COMPARIS ON OF CRYSTALLOID PRELOADING AND CRYSTALLOID COLOADING IN EMERGENCY CAESAREAN SECTION FOR FETAL DISTRESS: A PROSPECTIVE STUDY

Spinal anesthesia is widely used for emergency and elective C/S delivery. However its main drawback is hypotension which may cause nausea, vomiting and cardiovascular collapse and loss of consciousness in mother as well as fetal hypoxia and acidosis due to placental hypo perfusion. AIMS AND OBJECTIVE: To compare the incidence of hypotension in intraoperative period and to compare the fetal outcome in two groups (Preloading and co loading group). STUDY DESIGN: Prospective randomized double blind study. MATERIALS AND METHOD: This study was conducted in the obstetric emergency OT of Malda Medical College. 100 primi gravid mothers aged between 18- 29 years with ASA-1 physical status posted for emergency C/S for fetal distress was randomly allocated for either preloading (Group P) or co loading (Group C). RESULT AND ANALYSIS: Fluid requirement is significantly less in group C. There was no significant difference in the incidence of hypotension and ephedrine use. Fetal outcome in 1 min Apgar score in group C is significantly better as the baby could be delivered quickly in group C. CONCLUSION: Our study revealed that preloading can be safely avoided for spinal anesthesia in C/S for fetal distress. By using co loading method we can save valuable time required to deliver the baby and avoid circulatory overload without increasing the incidence of hypotension.