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Maternal Hypotension

MedGen UID:
457533
•Concept ID:
C2985307
•
Disease or Syndrome

Definition

A symptomatic decrease in baseline systolic or diastolic blood pressure in a pregnant woman that requires intervention. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVMaternal Hypotension

Professional guidelines

PubMed

Optimizing the management of acute, prolonged decelerations and fetal bradycardia based on the understanding of fetal pathophysiology.
Chandraharan E, Ghi T, Fieni S, Jia YJ
Am J Obstet Gynecol 2023 Jun;228(6):645-656. doi: 10.1016/j.ajog.2022.05.014. PMID: 37270260
Cesarean delivery fluid management.
Mercier FJ
Curr Opin Anaesthesiol 2012 Jun;25(3):286-91. doi: 10.1097/ACO.0b013e3283530dab. PMID: 22459983
The pregnant surgical patient: medical evaluation and management.
Barron WM
Ann Intern Med 1984 Nov;101(5):683-91. doi: 10.7326/0003-4819-101-5-683. PMID: 6435492

Recent clinical studies

Etiology

Optimizing the management of acute, prolonged decelerations and fetal bradycardia based on the understanding of fetal pathophysiology.
Chandraharan E, Ghi T, Fieni S, Jia YJ
Am J Obstet Gynecol 2023 Jun;228(6):645-656. doi: 10.1016/j.ajog.2022.05.014. PMID: 37270260
Modern labor epidural analgesia: implications for labor outcomes and maternal-fetal health.
Callahan EC, Lee W, Aleshi P, George RB
Am J Obstet Gynecol 2023 May;228(5S):S1260-S1269. Epub 2023 Mar 20 doi: 10.1016/j.ajog.2022.06.017. PMID: 37164496
Techniques for preventing hypotension during spinal anaesthesia for caesarean section.
Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS, Simmons SW, Cyna AM
Cochrane Database Syst Rev 2020 Jul 1;7(7):CD002251. doi: 10.1002/14651858.CD002251.pub4. PMID: 32619039Free PMC Article
SPINAL ANAESTHESIA-INDUCED HYPOTENSION IN OBSTETRICS: PREVENTION AND THERAPY.
Šklebar I, Bujas T, Habek D
Acta Clin Croat 2019 Jun;58(Suppl 1):90-95. doi: 10.20471/acc.2019.58.s1.13. PMID: 31741565Free PMC Article
Combined spinal-epidural versus epidural analgesia in labour.
Simmons SW, Taghizadeh N, Dennis AT, Hughes D, Cyna AM
Cochrane Database Syst Rev 2012 Oct 17;10(10):CD003401. doi: 10.1002/14651858.CD003401.pub3. PMID: 23076897Free PMC Article

Diagnosis

Third-trimester persistent maternal hypotension effects on late-onset small for gestational age and adverse perinatal outcomes.
Eraslan Sahin M, Sahin E, Kirlangic MM
PLoS One 2023;18(7):e0286900. Epub 2023 Jul 14 doi: 10.1371/journal.pone.0286900. PMID: 37450463Free PMC Article
Association Between Hyperbaric Bupivacaine Dose and Maternal Hypotension: Retrospective Database Study of 8226 Women Undergoing Cesarean Delivery Under Spinal Anesthesia.
Weiniger CF, Heesen M, Knigin D, Deutsch F, Hilber N, Avidan A
Anesth Analg 2021 Oct 1;133(4):967-975. doi: 10.1213/ANE.0000000000005518. PMID: 33780385
Nonobstetric Surgery During Pregnancy.
Tolcher MC, Fisher WE, Clark SL
Obstet Gynecol 2018 Aug;132(2):395-403. doi: 10.1097/AOG.0000000000002748. PMID: 29995718
Trauma in pregnancy.
Baerga-Varela Y, Zietlow SP, Bannon MP, Harmsen WS, Ilstrup DM
Mayo Clin Proc 2000 Dec;75(12):1243-8. doi: 10.4065/75.12.1243. PMID: 11126831
Epidural analgesia during labor.
Vincent RD Jr, Chestnut DH
Am Fam Physician 1998 Nov 15;58(8):1785-92. PMID: 9835854

Therapy

Techniques for preventing hypotension during spinal anaesthesia for caesarean section.
Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS, Simmons SW, Cyna AM
Cochrane Database Syst Rev 2020 Jul 1;7(7):CD002251. doi: 10.1002/14651858.CD002251.pub4. PMID: 32619039Free PMC Article
Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta-analysis of randomised controlled trials.
Fitzgerald JP, Fedoruk KA, Jadin SM, Carvalho B, Halpern SH
Anaesthesia 2020 Jan;75(1):109-121. Epub 2019 Sep 18 doi: 10.1111/anae.14841. PMID: 31531852
SPINAL ANAESTHESIA-INDUCED HYPOTENSION IN OBSTETRICS: PREVENTION AND THERAPY.
Šklebar I, Bujas T, Habek D
Acta Clin Croat 2019 Jun;58(Suppl 1):90-95. doi: 10.20471/acc.2019.58.s1.13. PMID: 31741565Free PMC Article
Update on volume therapy in obstetrics.
Teoh WH, Westphal M, Kampmeier TG
Best Pract Res Clin Anaesthesiol 2014 Sep;28(3):297-303. Epub 2014 Jul 17 doi: 10.1016/j.bpa.2014.07.004. PMID: 25208964
Combined spinal-epidural versus epidural analgesia in labour.
Simmons SW, Taghizadeh N, Dennis AT, Hughes D, Cyna AM
Cochrane Database Syst Rev 2012 Oct 17;10(10):CD003401. doi: 10.1002/14651858.CD003401.pub3. PMID: 23076897Free PMC Article

Prognosis

Maternal heart rate variability patterns associated with maternal hypotension and non-reassuring fetal heart rate patterns following initiation of combined spinal-epidural labor analgesia: a prospective observational trial.
Hyuga S, Parry R, Dan W, Onishi Y, Gallos G, Okutomi T
Int J Obstet Anesth 2023 May;54:103645. Epub 2023 Feb 28 doi: 10.1016/j.ijoa.2023.103645. PMID: 36930995
Maternal hypotension during fetoscopic surgery: incidence and its impact on fetal survival outcomes.
Ngamprasertwong P, Habli M, Boat A, Lim FY, Esslinger H, Ding L, Sadhasivam S
ScientificWorldJournal 2013;2013:709059. Epub 2013 Oct 21 doi: 10.1155/2013/709059. PMID: 24228013Free PMC Article
Maternal hypotension during spinal anesthesia for caesarean delivery.
Mercier FJ, Augè M, Hoffmann C, Fischer C, Le Gouez A
Minerva Anestesiol 2013 Jan;79(1):62-73. Epub 2012 Nov 18 PMID: 23135692
Trauma in pregnancy.
Baerga-Varela Y, Zietlow SP, Bannon MP, Harmsen WS, Ilstrup DM
Mayo Clin Proc 2000 Dec;75(12):1243-8. doi: 10.4065/75.12.1243. PMID: 11126831
Labour analgesia. A risk-benefit analysis.
Eberle RL, Norris MC
Drug Saf 1996 Apr;14(4):239-51. doi: 10.2165/00002018-199614040-00004. PMID: 8713692

Clinical prediction guides

Modern labor epidural analgesia: implications for labor outcomes and maternal-fetal health.
Callahan EC, Lee W, Aleshi P, George RB
Am J Obstet Gynecol 2023 May;228(5S):S1260-S1269. Epub 2023 Mar 20 doi: 10.1016/j.ajog.2022.06.017. PMID: 37164496
Techniques for preventing hypotension during spinal anaesthesia for caesarean section.
Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS, Simmons SW, Cyna AM
Cochrane Database Syst Rev 2020 Jul 1;7(7):CD002251. doi: 10.1002/14651858.CD002251.pub4. PMID: 32619039Free PMC Article
Maternal hypotension during spinal anesthesia for caesarean delivery.
Mercier FJ, Augè M, Hoffmann C, Fischer C, Le Gouez A
Minerva Anestesiol 2013 Jan;79(1):62-73. Epub 2012 Nov 18 PMID: 23135692
Combined spinal-epidural versus epidural analgesia in labour.
Simmons SW, Taghizadeh N, Dennis AT, Hughes D, Cyna AM
Cochrane Database Syst Rev 2012 Oct 17;10(10):CD003401. doi: 10.1002/14651858.CD003401.pub3. PMID: 23076897Free PMC Article
Trauma in pregnancy.
Baerga-Varela Y, Zietlow SP, Bannon MP, Harmsen WS, Ilstrup DM
Mayo Clin Proc 2000 Dec;75(12):1243-8. doi: 10.4065/75.12.1243. PMID: 11126831

Recent systematic reviews

Techniques for preventing hypotension during spinal anaesthesia for caesarean section.
Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS, Simmons SW, Cyna AM
Cochrane Database Syst Rev 2020 Jul 1;7(7):CD002251. doi: 10.1002/14651858.CD002251.pub4. PMID: 32619039Free PMC Article
A Systematic Review and Meta-analysis of Clinical Trials of Neuraxial, Intravenous, and Inhalational Anesthesia for External Cephalic Version.
Hao Q, Hu Y, Zhang L, Ross J, Robishaw S, Noble C, Wu X, Zhang X
Anesth Analg 2020 Dec;131(6):1800-1811. doi: 10.1213/ANE.0000000000004795. PMID: 32282385Free PMC Article
Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta-analysis of randomised controlled trials.
Fitzgerald JP, Fedoruk KA, Jadin SM, Carvalho B, Halpern SH
Anaesthesia 2020 Jan;75(1):109-121. Epub 2019 Sep 18 doi: 10.1111/anae.14841. PMID: 31531852
Combined spinal-epidural versus epidural analgesia in labour.
Simmons SW, Taghizadeh N, Dennis AT, Hughes D, Cyna AM
Cochrane Database Syst Rev 2012 Oct 17;10(10):CD003401. doi: 10.1002/14651858.CD003401.pub3. PMID: 23076897Free PMC Article
Prophylactic intravenous preloading for regional analgesia in labour.
Hofmeyr G, Cyna A, Middleton P
Cochrane Database Syst Rev 2004 Oct 18;2004(4):CD000175. doi: 10.1002/14651858.CD000175.pub2. PMID: 15494990Free PMC Article

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