Prophylactic Tredelenburg position for Reducing Maternal Hypotension and neonatal acidosis post Spinal Anesthesia in Cesarean Delivery
Journal Title: IOSR Journal of Nursing and health Science - Year 2019, Vol 8, Issue 1
Abstract
Background: During caesarean section mothers can be in different positions. Theatre tables could be tilted laterally, upwards, downwards and wedges or cushions could be used. There is no consensus on the best positioning at present.Spinal block givesadmirable and excellent anesthesia for cesarean delivery, but it is frequently accompanied by hypotension, which if untreated can pose serious risks to mother and baby.Strategies directed to increasing venous return, such asTredelenburg position( lifting the lower extremities), in the treatment of arterial hypotension This study aims to investigate Utilizationof tredelenburg positionfor decreasingmaternal hypotension and fetal acidosis following spinal anesthesia in cesarean delivery. A Quasi-experimental design used. Setting: The research was done at cesarean delivery operating unit AlazharUniversity Hospital throughout the period from first June 2017 till June 2018. Sample: A total of 380full-termsparturient with an uncomplicated pregnancyundergone plannedcesareandelivery underwent spinal anesthesiaberecruited in bothtredelenburg position group( Tgroup)leg elevation for 30 cm using two standard throwpillows placed under the heels by nurse for intervention group directly after spinal anesthesia and maintained till skin incisionand control group wereregular supine positionwere randomly allocated (190) women in each group).Protocol of pre-hydration and anesthetic technique standardizedwas followed. Tools:the data collected bystructuredinterviewing questionnaire sheet, maternal record, and neonatal assessment sheet. Results: Hypotension was significantly less (P = 0.001) in studygroup when compared withcontrol group.Ahighly statistical significant difference (P = 0.001) wasacquired between group managed by tredelenburg position andcontrolgroup considering mean arterial pressure and newly born acidosis. Conclusion: Incidence of hypotension can be reduced by tredelenburg position. Since Tredelenburg position ispainless, easy, noninvasive, available, and not pharmacological method, Recommendations: usage of tredelenburgposition during cesarean can be recommended for decreasing post spinal hypotension.
Authors and Affiliations
Maha Ali, Fatmazaki . , Amal Roshdi Ahmed mostafa, Amany El-berdan
Keywords
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- EP ID EP437645
- DOI 10.9790/1959-0801044249.
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