الفهرس 
CARDIOVASCULAR CHANGES DURING PREGNANCYOnly 14 pages are availabe for public view
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Abstract
Spinal anesthesia is frequently used for cesarean delivery
because of its rapid onset, a dense neural block, little risk
of local anesthetic toxicity and minimal transfer of drug to the
fetus. General anesthesia is preferred in emergency obstetric
situations, such as cord prolapse, in which there is a need for
reliable induction, and also bleeding placenta previa.
Unfortunately It is frequently accompanied by
hypotension, which may be defined in absolute terms as a
systolic blood pressure (SBP) of 90 or 100 mmHg or in relative
terms as a percentage (20% fall from baseline).
One of the ways to overcome this problem is to use
fluids as a preload before spinal anesthesia. This preloading
with intravenous fluids offset the vasodilating effects of
sympathetectomy caused by spinal anaesthesia thereby
maintaining the venous return and thus the DROP in blood
pressure is prevented.
Hypertonic saline can be used as a preload before spinal
anesthesia as it causes marked osmotic shift of fluid from the
intracellular to the interstitial and intravascular space thus
maintains intravascular volume and prevents spinal induced
hypotension.The aim of this study is to compare hypertonic
saline(3%)and normal saline (0.9%) in preventing spinal
induced hypotension.
In our study, 40 patients were randomly divided into 2
equal groups:
group A: received hypertonic saline (3%) (4ml/kg)
group B: received normal saline (0.9%)(13ml/kg)
Our study showed that hypertonic saline (3%) was more
effective than normal saline to prevent spinal induced
hypotension and it did not affect the neonatal outcome.