New inquiry is challenging what many obstetricians in addition to Dr. anesthesiologists believe is the best agency to seat women during labor. According to a written report published inwards the Feb number ofAnesthesiology, the official medical mag of the American Society of Anesthesiologists (ASAthe traditional do of positioning women on their side, amongst hips tilted at xv degrees, during task does non effectively trim compression of the inferior vena cava, a large vein located close the abdominal expanse that returns blood to the heart, equally previously thought. In fact, non until the bird of arguing reached thirty degrees did blood period of time alone partially increment inwards patients, the written report found.
It is widely believed that lying women apartment on their dorsum during task tin Pb to dangerously depression blood pressure level caused yesteryear the compression of both the inferior vena cava in addition to the aorta due to the weight of the fetus," said Hideyuki Higuchi, M.D., written report author, subdivision of anesthesiology, Tokyo Women's Medical University, Japan. "It is accepted yesteryear many physicians that positioning women on their side, amongst hips tilted at xv degrees, during childbirth reduces this complication. However, our inquiry flora no prove of aortic compression inwards important women inwards whatsoever seat in addition to the recommended bird of arguing that most physicians follow did non trim compression of the inferior vena cava at all. This is the outset written report to challenge this antiquated practice."
In the study, magnetic resonance images (MRI) of 10 important women at total term in addition to 10 non-pregnant women were obtained for mensuration of the abdominal aorta, the largest artery inwards the abdominal cavity, in addition to the inferior vena cava. Measurements were taken spell the women lay apartment on their dorsum in addition to spell tilted at 15, 30, in addition to 45 degrees. Foam was placed nether the correct side of the written report participants to accomplish the desired amount of tilt.
The written report flora that abdominal aortic blood book did non differ significantly betwixt important in addition to non-pregnant women regardless of the seat inwards which they were placed. Conversely, inferior vena cava blood book was significantly lower inwards important women than inwards non-pregnant women when the women were positioned apartment on their back, indicating almost consummate compression of the vein. Inferior vena cava blood book did non increment at xv degrees, but partially increased at thirty degrees.
An accompanying editorial commented favorably on the study's results, but offered a discussion of caution:
"Although it would live on cracking to live on able to conclude yesteryear proverb all of our patients inwards the delivery room should live on placed inwards at to the lowest degree thirty degrees left lateral arguing after regional anesthetic, I lead maintain serious doubts that our obstetric colleagues would uncovering it a reasonable seat for cesarean delivery, especially inwards fat patients," said editorial writer Craig Palmer, M.D., subdivision of anesthesiology, University of Arizona College of Medicine inwards Tucson, Ariz. "There quite likely are patients for whom the pocket-size (15 degree) arguing nosotros apply has a salutary effect. However, I volition lead maintain to live on less dogmatic nigh the practice. Kudos to the authors of this written report for revisiting an 'ancient' practice, applying electrical flow technology scientific discipline to the matter, in addition to shedding novel low-cal on an former routine."