Anesthesia for Cesarean Delivery: Effects on the Fetus of Maternal Blood Pressure Control
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AbstractFluctuations in maternal blood pressure during regional and general anesthesia for cesarean delivery may affect the fetus directly via uteroplacental perfusion or indirectly via effects of drugs used during management. During regional anesthesia, evidence supports active management to prevent hypotension using lateral uterine displacement, intravenous fluids and vasopressors. Ephedrine and phenylephrine are widely used but ephedrine depresses fetal pH, probably because of greater placental transfer and direct fetal effects compared with phenylephrine. During general anesthesia, hypertension may occur after tracheal intubation and from use of light anesthesia. This may increase circulating catecholamines which can decrease uteroplacental blood flow. Opioids, particularly remifentanil may be used in selected cases to attenuate the hypertensive response. Hypotension occasionally occurs from the depressant effects of general anesthetic drugs and can be managed with fluids and vasopressors. During emergency maternal resuscitation, the usual drugs should be used to restore cardiac output as fast as possible. © 2013 Blackwell Publishing Ltd.
All Author(s) ListKee W.D.N.
All Editor(s) Listed. by Ginosar Y, Reynolds F, Halpern S, Weiner C.
Detailed descriptioned. by Ginosar Y, Reynolds F, Halpern S, Weiner C.
Pages235 - 243
LanguagesEnglish-United Kingdom
KeywordsAnesthesia, Preeclampsia, Vasodilatation, Vasopressors

Last updated on 2020-24-09 at 00:54