Combined Colloids And Crystalloids Versus Crystalloids in Women With Preeclampsia Undergoing Cesarean Delivery

Combined Colloids And Crystalloids Versus Crystalloids in Women With Preeclampsia Undergoing Cesarean Delivery Under Spinal Anesthesia: A Randomized Controlled Trial

This study will compare between combination of colloids/crystalloids and crystalloids in women with preeclampsia undergoing elective cesarean delivery under spinal anesthesia

This randomized, controlled, double blind study will be conducted on women with preeclampsia with singleton pregnancy undergoing elective cesarean delivery under spinal anesthesia. Immediately, after spinal anesthesia administration, patients will receive either 250 mL colloid over 5 minutes followed by 500 mL crystalloid over 55 minutes then 250 mL colloid over 60 minutes (Combination group) or 250 mL crystalloid over 5 minutes followed by 500 mL over 55 minutes then 250 mL over 60 minutes (Crystalloid group). The studied maternal outcomes will be the urine output, ephedrine requirement, incidence of hypotension, inferior vena cava diameters, nausea/vomiting and bradycardia. Neonatal Apgar scores will be recorded at 1 and 5 minutes post-delivery.

Inclusion Criteria:

• Preeclampsia: Blood Pressure ≥140/90 mmHg after 20 weeks' gestation and proteinuria ≥300 mg/24 hours or 1+ on urine dipstick
• Singleton pregnancy
• Elective cesarean delivery under spinal anesthesia

Exclusion Criteria:

• Height <150 cm
• Weight <60 kg
• Body mass index ≥45 kg/m2
• Women presenting in labor
• Contraindications to spinal anesthesia (increased intracranial pressure or local skin infection)
• Diabetes mellitus, cardiovascular, cerebrovascular, or renal disease
• Preoperative administration of intravenous hydralazine or magnesium sulphate
• Hemoglobin <10 gm/dL
• International Normalized Ratio >1.3
• Platelet count <100,000 /mm3
• Preoperative serum creatinine >1.1 mg/dL