Aim: The aim of this study is to evaluate the effects of ephedrin on maternal and fetal blood flow in elective cesarean section (CS) undergoing spinal anesthesia with Doppler ultrasonography measurements. Method: This prospective, double-blind randomized study was conducted on 40 pregnant women who underwent CS and had no contraindications for spinal anesthesia. The subjects included in the study were divided into 2 groups as the group that received ephedrine (n=20) and the control group (n=20) that did not receive ephedrine. Doppler measurements such as peak systolic velocity (S), end-diacytolic velocity (D), S/D ratio, resistivity index (RI) and pulsatility index (PI) of the uterine artery from the mother and the umbial artery from the fetus before and after spinal anesthesia of the pregnant women in both groups was recorded. Results: The groups were matched for age, body mass index, gestational age, and indication for cesarean section. There was a statistically significant decrease in diastolic blood pressure in the ephedrine group (p<0.001). There was a significant increase in the S/D ratio in the control group (p=0.029). APGAR scores were similar between the groups (p>0.05). Conclusion: Prophylactic administration of ephedrine under spinal anesthesia in pregnant women can prevent the decrease in uteroplacental perfusion and protect the fetus from possible fetal hypoxia and acidosis.
Amaç: Bu çalışmanın amacı, spinal anestezi uygulanan elektif sezaryen yapılan hastalarda efedrinin maternal ve fetal kan akımı üzerindeki etkilerini Doppler ultrasonografi ölçümleri ile değerlendirmektir. Yöntem: Bu prospektif çift kör randomize çalışma elektif sezaryen uygulanan ve spinal anestezi için herhangi bir kontrendikasyonu olmayan kırk gebe kadın üzerinde yürütülmüştür. Çalışmaya alınan denekler efedrin alan grup (n=20) ve efedrin almayan kontrol grubu (n=20) diye 2 gruba ayrıldı. Her iki gruptaki gebelerin spinal anestezi öncesinde ve sonrasında her bir kadın için uterin arter ve fetal umbilikal arter tepe sistolik hız (S), diyasitol sonu hız (D), S/D oranı, rezistivite indeksi (RI) ve pulsatilite indeksi (PI) gibi Doppler ölçümleri kaydedildi. Bulgular: İki grup yaş, vücut kitle indeksi, gebelik yaşı ve sezaryen endikasyonu açısından eşleştirildi. Spinal anestezi öncesi (herhangi bir işlem uygulamadan önce) kontrol grubu ve efedrin grubu arasında ultrasonografik Doppler ölçüm değerleri arasında istatiksel olarak anlamlı bir fark yoktu. Efedrin grubunda diyastolik kan basıncında istatistiksel olarak anlamlı bir düşüş vardı (p<0.001). Kontrol grubunda S/D oranında da anlamlı bir artış (p=0.029) vardı. APGAR skorları 2 grup arasında benzerdi (p>0.05). Sonuç: Gebelerde spinal anestezi sırasında profilaktik efedrin uygulaması, maternal uterin arterdeki S/D artışının önüne geçerek uteroplasental perfüzyonda meydana gelebilecek engelleyebilir ve fetüsü olası hipoksi ve asidozdan koruyabilir.
Primary Language | Turkish |
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Subjects | Health Care Administration |
Journal Section | Articles |
Authors | |
Publication Date | August 31, 2022 |
Submission Date | April 8, 2022 |
Acceptance Date | July 26, 2022 |
Published in Issue | Year 2022 Volume: 15 Issue: 2 |
MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.
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