Plethysmography Variability Index Monitoring for Parturients With Antepartum Hemorrhage

Continuous Non Invasive Monitoring of Both Plethysmography Variability Index and Total Hemoglobin During Cesarean Section for Antepartum Hemorrhage As a Method For Early Detection of Bleeding

The purpose of this study is to evaluate the use of continuous noninvasive intraoperative plethesmography variability index in conjunction with Hemoglobin levels monitoring using Masimo Radical-7™ Pulse CO-Oximeter during elective cesarean sections in patients with antepartum and intrapartum hemorrhage as a guide for fluid and blood transfusion practice .

Inclusion Criteria:

• Anesthesiologist (ASA) Physical status I - II.
• patients aged from 18 to 40 years
• full-term multigravida parturients
• antepartum hemorrhage
• singleton fetus

Exclusion Criteria:

• Patients with known cardiac problem
• peripheral circulatory failure of the upper extremities
• significant liver disease
• significant renal disease
• significant coagulopathy