Key result
Crystalloid infusion and epidural anaesthesia significantly decreased maternal uteroplacental and fetal umbilical artery systolic/diastolic ratios during elective caesarean section.
Why the study?
Does epidural anaesthesia with crystalloid infusion improve maternal uterine and fetal umbilical artery blood flow in normal patients undergoing elective caesarean section?
Does epidural anaesthesia with crystalloid infusion improve maternal uterine and fetal umbilical artery blood flow in normal patients undergoing elective caesarean section?
Epidural anaesthesia with crystalloid infusion appears to have a beneficial fetal effect by improving maternal uterine perfusion and decreasing blood flow resistance.
May support better uteroplacental flow with epidural plus crystalloid in elective caesarean; hypothesis-generating and requires randomized confirmation.
Summary. The blood flow resistance in the maternal uteroplacental and fetal umbilical artery circulation was studied in eight otherwise normal patients undergoing elective lower segment caesarean section. The systolic/diastolic A/B ratio (the ratio of peak systolic to least diastolic flow velocity) for the uteroplacental and fetal umbilical circulation was determined from the artery blood flow velocity-time waveform and used as an index of blood flow resistance. Each patient received a 1 litre intravenous crystalloid infusion before an epidural bupivicaine injection. Both crystalloid infusion and epidural anaesthesia resulted in a significant decrease in the maternal uteroplacental systolic/diastolic (A/B) ratios, associated with a decrease in fetal umbilical artery A/B ratio. This study suggests a beneficial fetal effect from the improved maternal uterine perfusion after epidural anaesthesia.
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Giles et al. (1987) studied Elective lower segment caesarean section (n=8). Intravenous crystalloid infusion and epidural bupivacaine vs. Baseline was evaluated on Maternal uteroplacental and fetal umbilical artery systolic/diastolic (A/B) ratios. Crystalloid infusion and epidural anaesthesia significantly decreased maternal uteroplacental and fetal umbilical artery systolic/diastolic ratios during elective caesarean section.