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dc.contributor.authorDennis ATen_US
dc.contributor.authorBuckley Aen_US
dc.contributor.authorMahendrayogam Ten_US
dc.contributor.authorCastro JMen_US
dc.contributor.authorLeeton Len_US
dc.description.abstractOptimal positioning for anaesthesia in pregnant women involves balancing the need for ideal tracheal intubation conditions (achieved by the head elevated ramped position), with the prevention of reduced cardiac output from aortocaval compression (achieved by left lateral pelvic tilt). No studies have examined the effect on cardiac output of left lateral pelvic tilt in the ramped position. We studied non-labouring, non-anaesthetised healthy term pregnant women who underwent baseline (left lateral decubitus) cardiac assessment using transthoracic echocardiography. We then compared cardiac output, maternal physiological variables, fetal heart rate and comfort scores in three positions: left lateral decubitus; ramped position with wedge; and ramped position alone. Thirty women completed the study. Mean (SD) age, gestation and body mass index were 33.5 (3.93) years, 38.5 (0.94) weeks and 29.0 (4.0) kg.m-2 , respectively. Mean ejection fraction, left ventricular internal diameter and mitral valve E/e' were 55.2 (6.8) %, 4.70 (0.43) cm and 7.50 (1.82), respectively. There were no differences in cardiac output between the positions (p = 0.503). There were no differences in systolic (p = 0.955) or diastolic (p = 0.987) blood pressure, maternal heart rate (p = 0.133), oxygen saturation, respiratory rate (p = 0.964) or fetal heart rate (p = 0.361) between ramped with wedge and ramped alone positions. Left lateral decubitus was most comfortable (p = 0.001), however, there were no differences in comfort levels between ramped with wedge and ramped alone positions. The ramped position without left lateral tilt is safe and acceptable in non-labouring, non-anaesthetised, healthy term pregnant women. Left lateral pelvic tilt may be unnecessary in the head elevated ramped position in term pregnant women.en_US
dc.subjectpatient positioningen_US
dc.subjectcardiac outputen_US
dc.titleEchocardiographic determination of resting haemodynamics and optimal positioning in term pregnant womenen_US
dc.typeJournal Articleen_US
dc.identifier.doidoi: 10.1111/anae.14418en_US
dc.description.affiliatesDepartment of Anaesthesia, The Royal Women's Hospital, Parkville, Australiaen_US
dc.description.affiliatesDepartment of Obstetrics and Gynaecology and Department of Pharmacology, The University of Melbourne, Parkville, Australiaen_US
dc.description.affiliatesDepartment of Anaesthesia, Austin Health, Heidelberg, Australiaen_US
dc.description.affiliatesDepartment of Anaesthesia, Addenbrookes Hospital, Cambridge, UKen_US
dc.description.affiliatesDepartment of Cardiology, St Vincent's Hospital, Fitzroy, Australiaen_US
dc.type.studyortrialCase Control Studiesen_US
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
Appears in Collections:Scholarly and Clinical
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