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ST segment depression during labor and delivery.

Publication ,  Journal Article
Mathew, JP; Fleisher, LA; Rinehouse, JA; Sevarino, FB; Sinatra, RS; Nelson, AH; Prokop, EK; Rosenbaum, SH
Published in: Anesthesiology
October 1992

ECG changes suggestive of myocardial ischemia are common during cesarean delivery under regional anesthesia. To determine the time course, duration, and significance of these ECG changes, we monitored 111 parturients with continuous ambulatory ECG (Holter) during and after cesarean delivery. Twenty-two parturients undergoing vaginal delivery were similarly monitored. ST segment depression was present in 25% of patients undergoing cesarean delivery but was not found in those patients delivering vaginally. ST segment elevation was not detected in either group. The incidence of ST segment depression during cesarean delivery was similar with epidural (29%), spinal (17%), and general (18%) anesthesia, occurring most commonly in the 30 min following delivery (P less than 0.001). Transthoracic echocardiographic imaging was performed in 23 patients undergoing cesarean section. Five of the 23 patients had seven episodes of intraoperative ST segment depression. Regional wall motion abnormalities were not present in any patient. A decrease in ejection fraction area greater than 15% from baseline or from previous interval ejection fraction area was present during four episodes of ST change. Three episodes of ST depression were not associated with significant decreases in ejection fraction area. Precordial Doppler monitoring for detection of venous air embolism in 25 patients revealed no association between the occurrence of venous air embolism and ST segment depression. We conclude that although significant myocardial impairment during cesarean delivery does not occur, episodes of ST depression may not all be merely an artifact of parturition.

Duke Scholars

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

October 1992

Volume

77

Issue

4

Start / End Page

635 / 641

Location

United States

Related Subject Headings

  • Veins
  • Prospective Studies
  • Pregnancy
  • Labor, Obstetric
  • Incidence
  • Humans
  • Female
  • Embolism, Air
  • Electrocardiography, Ambulatory
  • Depression, Chemical
 

Citation

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Mathew, J. P., Fleisher, L. A., Rinehouse, J. A., Sevarino, F. B., Sinatra, R. S., Nelson, A. H., … Rosenbaum, S. H. (1992). ST segment depression during labor and delivery. Anesthesiology, 77(4), 635–641. https://doi.org/10.1097/00000542-199210000-00004
Mathew, J. P., L. A. Fleisher, J. A. Rinehouse, F. B. Sevarino, R. S. Sinatra, A. H. Nelson, E. K. Prokop, and S. H. Rosenbaum. “ST segment depression during labor and delivery.Anesthesiology 77, no. 4 (October 1992): 635–41. https://doi.org/10.1097/00000542-199210000-00004.
Mathew JP, Fleisher LA, Rinehouse JA, Sevarino FB, Sinatra RS, Nelson AH, et al. ST segment depression during labor and delivery. Anesthesiology. 1992 Oct;77(4):635–41.
Mathew, J. P., et al. “ST segment depression during labor and delivery.Anesthesiology, vol. 77, no. 4, Oct. 1992, pp. 635–41. Pubmed, doi:10.1097/00000542-199210000-00004.
Mathew JP, Fleisher LA, Rinehouse JA, Sevarino FB, Sinatra RS, Nelson AH, Prokop EK, Rosenbaum SH. ST segment depression during labor and delivery. Anesthesiology. 1992 Oct;77(4):635–641.

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

October 1992

Volume

77

Issue

4

Start / End Page

635 / 641

Location

United States

Related Subject Headings

  • Veins
  • Prospective Studies
  • Pregnancy
  • Labor, Obstetric
  • Incidence
  • Humans
  • Female
  • Embolism, Air
  • Electrocardiography, Ambulatory
  • Depression, Chemical