EFFECT OF VASOPRESSORS ON FOETAL UMBILICAL ARTERIAL BLOOD AFTER SPINAL ANAESTHESIA FOR CAESAREAN SECTION

BACKGROUND Maternal hypotension produces unpleasant symptoms such as nausea, vomiting and light headedness. More importantly, when severe and sustained, hypotension can impair uterine and intervillous blood flow and ultimately result in foetal acidosis and neonatal depression. Preventive measures include fluid preload, left lateral tilt, and use of vasopressors. Aims and Objectives- 1. To study the effectiveness of Ephedrine and Phenylephrine in the treatment of hypotension secondary to spinal anaesthesia. 2. To study the effect of vasopressors on foetal/neonatal outcome. MATERIALS AND METHODS In this open labelled randomised controlled trial, parturients were randomly divided into two groups. They were assigned to receive one of the two vasopressor solutions whenever maternal systolic arterial pressure (SAP) and heart rate (HR) decreased to 80% of baseline or less. SAP is measured every minute by automated oscillometry and the maternal HR by finger pulse oximetry. The sample size estimation was also done at conveniences. RESULTS There was no statistically significant difference between two groups in age, gender and weight of the patient and both groups were comparable. Both ephedrine and phenylephrine were effective in managing hypotension. Phenylephrine has high efficacy in increasing blood pressure. There was a decrease in pH in patients who received ephedrine as bolus dose for hypotension, but APGAR scores were good for all newborn infants. CONCLUSION Phenylephrine proves to be a better option in managing hypotension with minimal effects on foetus.