Key result
Applying extra-abdominal uterine fundal pressure during Caesarean section significantly decreased cardiac output (3.85 vs 4.69 l/min) and blood pressure (84.7 vs 100.3 mmHg) (p < 0.05).
Why the study?
Does the application of extra-abdominal uterine fundal pressure affect maternal haemodynamics in women undergoing Caesarean section?
Observational (n=20)
Does the application of extra-abdominal uterine fundal pressure affect maternal haemodynamics in women undergoing Caesarean section?
p-value: p=<0.05
Applying fundal pressure during Caesarean delivery produces significant but likely clinically insignificant haemodynamic effects.
Does not support avoiding fundal pressure in routine Caesarean sections; leaves open risks in haemodynamically unstable patients.
In 20 women undergoing Caesarean section, we determined brachial arterial blood pressure, heart rate and cardiac output (using an oesophageal Doppler probe) just after uterine incision and during the application of extra-abdominal uterine fundal pressure to facilitate delivery. Mean (SD) systolic aortic flow time (354.3 (35.4) ms), cardiac output (3.85 (0.68) l.min(-1)), heart rate (80.6 (14.2) beats.min(-1)) and blood pressure (84.7 (12.1) mmHg) decreased when fundal pressure was applied compared with after uterine incision (397.6 (31.6) ms, 4.69 (0.78) l.min(-1), 95.1 (14.0) beats.min(-1)and 100.3 (12.0) mmHg, respectively; p < 0.05). Peak velocity and stroke distance of the aortic flow when fundal pressure was applied was similar to after uterine incision. The mothers and babies were not observed to be clinically compromised. The results suggest that applying fundal pressure to facilitate Caesarean delivery produces significant haemodynamic effects but the impact of these effects may be clinically insignificant.
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Kim et al. (2006) conducted an observational in Caesarean section (n=20). Extra-abdominal uterine fundal pressure vs. Just after uterine incision (prior to fundal pressure) was evaluated on Maternal haemodynamics (systolic aortic flow time, cardiac output, heart rate, and blood pressure) (p=<0.05). Applying extra-abdominal uterine fundal pressure during Caesarean section significantly decreased cardiac output (3.85 vs 4.69 l/min) and blood pressure (84.7 vs 100.3 mmHg) (p < 0.05).
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