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There is high incidence of hypertensive disorders during pregnancy.The maternal cardiovascular system had significant changes during pregnancy. The colloid oncotic pressure is decreased during preeclampsia.
Transthoracic echocardiography considered an accurate non-invasive device and has validity for measuring cardiac functions in pregnancy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Crystalloid group | Active Comparator | The patients will receive 1000 mL of ringer's acetate solution (250 mL over 5 minutes starting immediately after intrathecal injection using a pressurizer then 500 mL over 55 minutes then 250 mL over 60 minutes). |
|
| Crystalloid-colloid group | Active Comparator | Patients will receive 250 mL 6% hydroxyethyl starch 130/0.4 in 0.9% sodium chloride starting immediately after intrathecal injection then 500 mL of ringer's acetate solution then 250 mL of hydroxyethyl starch |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 1000 mL of ringer's acetate solution | Drug | 1000 mL of ringer's acetate solution |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Cardiac output measurement | 1 hour post spinal anesthesia after administration of 1000 mL fluid using Transthoracic Echocardiography | 1 hour from the spinal anesthesia |
| Measure | Description | Time Frame |
|---|---|---|
| Cardiac output measurement | at baseline ,5 minutes after spinal anesthesia, after delivery of the fetus and 2 hours post spinal anesthesia | 5 minutes after the spinal anesthesia, after delivery of the fetus and 2 hours post spinal anesthesia |
| Left ventricular end diastolic volume (LVEDV) measurement |
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Inclusion Criteria:
Exclusion Criteria:
Singleton pregnant preeclampsia scheduled for elective cesarean section delivery under spinal anesthesia
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mansoura University-Emergency hospital-ICU | Al Mansurah | Mansoura | 35511 | Egypt |
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| ID | Term |
|---|---|
| D006895 | Hydroxyethyl Starch Derivatives |
| C485123 | HES 130-0.4 |
| ID | Term |
|---|---|
| D013213 | Starch |
| D004040 | Dietary Carbohydrates |
| D002241 | Carbohydrates |
| D005936 | Glucans |
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Patients will be randomly allocated via sealed opaque envelops into 2 groups of 17 patients each; crystalloid group and group crystalloid-colloid group
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All the fluids were prepared according to the group by an anesthetist who will not be involved in data collection. All the bottles were wrapped by opaque cover.
| 250 mL 6% hydroxyethyl starch (Voluven) then 500 mL of ringer's acetate solution then 250 mL of 6% hydroxyethyl starch (Voluven) |
| Drug |
500 mL 6% hydroxyethyl starch 130/0.4 in 0.9% sodium chloride plus 500 mL of ringer's acetate solution |
|
milliliter |
| 1 hour from the spinal anesthesia |
| Urine output volume | milliliters | 1hour and 2 hours post spinal anesthesia |
| Heart rate (HR) | beats per minute | basal (preoperative), intraoperative each 10 minutes and postoperatively every hour during first 6 hours |
| Mean Blood pressure | mmHg | basal (preoperative), intraoperative each 10 minutes and postoperatively every hour during first 6 hours |
| D011134 |
| Polysaccharides |