Efecto de la lateralización de la embarazada en el gasto cardiaco medido por ecografía transtorácica

Abstract

Background: Aorta-caval compression in supine position was recognized as a cause of hypotension in the last trimester of pregnancy in 1953. This compression can cause hemodynamic changes and utero-placental hypoperfusion, so it is recommended to perform the lateral position in the term pregnant woman. Materials and Methods: We studied 60 patients who were scheduled for elective cesarean section. Prior to the anesthetic induction, in dorsal decubitus (DD), the left ventricular outflow tract (LVOT) was measured in the parasternal long a×is, and then the velocity-time integral (VTI) was obteined from the Apical 5-chamber view. After that the patients were placed in the left lateral decubitus position (LLD) and VTI was re-measured after 3 minutes. The estimation of the Cardiac output(CO) was made by the formula: VTI × (r2 LVOT × 3.14) × HR. Results: The average age was 33.7 years. The CO was higher when the patient was in LLD compared to DD (6,727 ± 234 ml ml vs 5,795 ± 276 ml, p < 0.001). This increase was 16.2%. In the LLD position. Discussion: This study evidenced that echocardiography is a good tool for estimating CO during the lateralization of the pregnant woman. Conclusion: In patients with full-term pregnancy, echocardiography showed a significant increase in CO in LLD compared to DD, which is why we affirm the veracity of this maneuver.