Key result
Pre-operative blood pressure control with hydralazine in pre-eclamptic parturients did not improve APGAR scores but reduced intra-operative fluid requirements (478 ml vs 635 ml, p=0.001).
Why the study?
Does pre-operative control of blood pressure with hydralazine improve foeto-maternal outcomes in pre-eclamptic parturients undergoing caesarean section under spinal anaesthesia?
Observational (n=60)
Single-blind
No
Does pre-operative control of blood pressure with hydralazine improve foeto-maternal outcomes in pre-eclamptic parturients undergoing caesarean section under spinal anaesthesia?
Answers are grounded in this paper and cite their sources.
Pre-operative control of blood pressure in mildly pre-eclamptic parturients undergoing caesarean section under spinal anaesthesia does not significantly improve maternal hemodynamics or neonatal APGAR scores, suggesting it may not be mandatory.
The foeto-maternal out come in pre-eclamptic parturients under going caesarean section under SAB with or without pre-operative control of blood pressure were studied. A total of 60, 30 in each group primpara women with singleton pregnancy diagnosed as pre-eclampsia scheduled for caesarean section were included. In Group-A, patients were treated with Hydralazine 5mg increment dose at 20 min. intervals till the DBP at or below 90 mm Hg. In Group-B, patients did not receive any anti hypertensive therapy. The patients were pre-loaded in both groups with lactated Ringer's solution at 15ml/kg over 20-30 minutes. The SBP, DBP and heart rate were recorded before block, just after block, every two minutes for 1st 10 minutes and then every five minutes till on arrival of post operative ward. Neonatal assessment was done using APGAR score at 1 and 5 minutes. There was no significant changes of SBP between the groups throughout the study period. But there was significant difference in intra-operative fluid requirement in two groups (478 ml vs. 635m1;; P=0.0001). The Ephedrine requirements were almost similar in two groups. There was no significant differences of APGAR scores in two groups. This study gave the understanding that pre-operative control of BP of mildly pre-eclamptic parturient is not mandatory for caesarean section under spinal anaesthesia.DOI: http://dx.doi.org/10.3329/jbsa.v17i1.4048 Journal of BSA, Vol. 17, No. 1 & 2, 2004 p.28-31
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Hossain et al. (2009) conducted an observational in Pre-eclampsia (n=60). Hydralazine vs. No anti-hypertensive therapy was evaluated on Intra-operative fluid requirement (ml) (p=0.001). Pre-operative blood pressure control with hydralazine in pre-eclamptic parturients did not improve APGAR scores but reduced intra-operative fluid requirements (478 ml vs 635 ml, p=0.001).
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