Изменения маточно-плацентарной гемодинамики при кесаревом сечении и пути ее оптимизации

Abstract

The objective: to examine the effects of spinal anesthesia (SA) in the mother and Central hemodynamics parameters blood in utero-placenta vascular circuit when childbirth women operation of caesarean section (CS), practicing techniques to optimize utero-placental hemodynamics. Materials and methods. In order to practice the technique of optimizing hemodynamics of the mother and uteroplacental vascular circuit during the MCA surgery, the CS performed a series of Doppler ultrasound studies in 34 women who underwent the MCA to anesthetize the planned operation, prior to the onset of uterine contractile activity. Blood flow parameters in the uterine arteries and umbilical arteries were evaluated. The measurements were performed using the apparatusPhilips HD 11XE. Results. It has been established that the SA in women with anesthetic, there is a problem quickly advancing and more expressed arterial hypotension, compared with patients’ gynecological operations. Justified and refined technique of optimization of hemodynamics of mother and utero-placental vascular path while carrying out operations by introducing the SA for CS mini-doses of oxytocin (0,1–0,5 units) at the beginning of the spinal anesthesia, which helped to improve the degree of anesthesia safety benefits to the mother and fetus. Conclusion. Use in pregnant women under the influence of spinal anesthesia, carried out with the aim of anesthesia of cesarean section, intravenous administration of oxytocin in a mini-dose (0.1–0.5 units) prevents the development of early and severe arterial hypotension by reducing the potential capacity of the uterine vascular bed and it does not have a negative impact on the state of the fetus. Key words: caesarean section, spinal anesthesia, hemodynamics.