الفهرس Only 14 pages are availabe for public view
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Abstract
Hypotension is the most common physiological consequence of spinal anesthesia in parturient undergoing cesarean section due to sympathectomy resulting from the neuroaxial blockade. The aim of this study was to combine different methods used to decrease the incidence of hypotension in order to prevent dangerous maternal and fetal complications in a bundle called maternal care bundle. Maternal care bundle applied in the study included low fixed dose of bupivacaine (7.5 mg) with fentanyl (25 æg), crystalloid coloading (10 ml/kg), preemptive use of vasopressors (ephedrine 9mg), patient positioning (left lateral position) and leg compression with graduated compression stocking. The bundle was applied to all female patients undergoing Cesarean section with spinal anesthesia at Kasr AL Ainy. Patients with medical contraindications to spinal anesthesia were excluded. Comparison with the recently announced incidence of hypotension at Kasr AL Ainy in normal practice was done. Results showed significant reduction of the incidence of hypotension from 65.09% to 26.4% in the whole duration of the procedure and 17.6% after 5 minutes of spinal anesthesia administration. The bundle as well decreased the incidence of maternal nausea and vomiting to 17%, and 9.4% respectively.Conclusion was maternal care bundle is highly recommended to be applied to decrease the incidence of spinal induced hypotension in parturient undergoing cesarean section in order to avoid harmful maternal and fetal consequences