[Doppler flow changes in maternal and fetal blood vessels before and during peridural anesthesia].
26 women with an uneventful singleton pregnancy near term underwent scheduled Caesarean section with lumbar epidural anaesthesia (PDA). Doppler-flow measurements of the foetal umbilical artery and the maternal hypogastric artery were taken before and after sympathicolysis was established. The mean arterial blood pressure was maintained unchanged between the measurements. Both measurements were performed by the same examiner. Three patients received additional general anaesthesia during the operation because of inadequate analgesia. The resistance index (RI) with PDA decreased significantly in 23 patients by a mean of 7.6% (p less than 0.05). The RI in those patients (n = 3) with inadequate analgesia increased by a mean of 27%. The physiologically reversed diastolic flow in the maternal hypogastric artery was mathematically taken into consideration by applying the quotient of the systolic flow and the diastolic reversed flow (V/R-quotient). The V/R-quotient increased with established sympathicolysis by more than 180% in all but one patient. The neonates' mean umbilical artery pH was 7.32 (7.27 to 7.41), the mean five minute Apgar score was 10 (8 to 10).
Frauenklinik und Poliklinik rechts der Isar.
K T
KT
Schneider
R
R
Deckardt
M
M
Rust
E A
EA
Dumler
H
H
Graeff
D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange / Q000187:drug effects* / Q000502:physiology; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000187:drug effects
Dopplerflussverhalten in mütterlichen und fetalen Gefässen vor und während Periduralanästhesie.