International journal of obstetric anesthesia
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The cardiovascular changes during epidural caesarean delivery were studied, using a non-invasive cardiac output monitor (BoMed NCCOM3-R7). Two different regimens were used to control hypotension (A = 15 ml/kg of 3% dextran 70, B = 7.5 ml/kg of 3% dextran 70 followed by an infusion of 17.5 mg of ephedrine). ⋯ The increase in cardiac output after delivery was greater than that measured previously, which might be because impedance cardiac output is a continuous method. It is also suggested that the most pronounced changes are augmented by the use of a bolus injection of 10 units oxytocin i.v.
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Int J Obstet Anesth · Jan 1994
A comparison of spinal and general anaesthesia for elective caesarean section: effect on neonatal condition at birth.
The condition of 74 neonates delivered by elective caesarean section under general anaesthesia was compared with that of 63 neonates delivered under spinal anaesthesia. When the uterine incision - delivery interval was less than 3 min, neonates in the spinal group exhibited a higher Apgar score at 1 min (P < 0.002) and a higher mean umbilical venous pH (P < 0.05) than the equivalent general anaesthesia group; a significantly greater proportion of the neonates delivered under general anaesthesia had an umbilical venous pH<7.28 at delivery (P < 0.05), a fact which previous work suggests is important. Among anaesthetized mothers inspired oxygen concentration (33% or 50%) before delivery had no significant effect upon neonatal outcome. It is concluded that neonates delivered at elective Caesarean section under spinal anaesthesia are in better condition than those delivered under general anaesthesia.
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Int J Obstet Anesth · Jan 1994
A case of hyperemesis gravidarum treated with artificial nutritional support.
A case of severe hyperemesis gravidarum is described in which the parturient required nutritional support. Initially a trial of enteral feeding was attempted but was unsuccessful. Subsequent parenteral nutrition allowed the remainder of the pregnancy to continue and a live infant was delivered by caesarean section at 34 weeks gestation. Criteria for using artificial feeding, the nutritional requirements of a pregnant woman and the potential hazards to the pregnancy by giving artificial nutritional support are reviewed.