Patients will receive Phenylephrine 30 µg/minute by syringe pump infusion for 30 minutes.

Patients will receive Ephedrine 3 mg/ minute by syringe pump infusion for 30 minutes.

Spinal Hypotension

50 patients will receive Phenylephrine 30 µg/minute by syringe pump infusion for 30 minutes.

Phenylephrine

50 patients will receive Ephedrine 3 mg/ minute by syringe pump infusion for 30 minutes.

Ephedrine

Assiut university hospital

Ephedrine and Phenylephrine for Spinal Hypotension

Ephedrine Versus Phenylephrine Infusion for Prevention of Spinal Hypotension During Cesarean Section: Effect on Maternal Cardiodynamics and Fetal Circulation: Randomized Double-blind Study

maternal cardiac output will be done using non-invasive thoracic bio-impedance monitor

uterine blood flow indices will be done using Doppler

Percentage of patients with any complications will be recorded and treated

MOHAMED F. MOSTAFA

Lecturer of Anesthesia and Intensive Care

Assiut University

W&D should begin when participants wish to conceive. The intervention was standardized by training of research staff. Careful instructions about walking speed and diet would be given to participants assigned to W&D at enrolment and at each consultation.

No recommendations regarding diet or physical activity were given to controls. Antiemetics such as ondansetron would be given to controls complaining of vomiting.

The intervention was standardized by training of research staff and should begin when participants wish to conceive. Careful instructions about walking speed and diet would be given to participants assigned to W&D at enrolment and at each consultation.
Walking & dietary modification: 1. Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those whose jobs required them to seat for long periods should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, such as near term.
2. At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water or sugar-sweetened beverages. Sucralose could be used as a sweetener. Participants were recommended to use ondansetron for nausea and vomiting prevention

Walking & Dietary Modification (W&D)

Controls

Total

Sex: Female, Male

Race (NIH/OMB)

Region of Enrollment

Normal or underweight (BMI <25 kg/m2)

Owerweight (BMI 25–30 kg/m2)

Obese (BMI > 30 kg/m2)

Type 1 diabetes mellitus

Chronic hypertension

Women with live offspring

The intervention was standardized by training of research staff and should begin when participants wish to conceive. Careful instructions about walking speed and diet would be given to participants assigned to W&D at enrollment and at each consultation.
Walking & dietary modification: 1. Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those whose jobs required them to seat for long periods should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, such as near term.
2. At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water, sugar-sweetened beverages and large amount of fruits. Sucralose could be used as a sweetener. Participants were recommended to use ondansetron for nausea and vomiting prevention

Take-home Baby Rate

The intervention was standardized by training of research staff and should begin when participants wish to conceive. Careful instructions about walking speed and diet would be given to participants assigned to W&D at enrollment and at each consultation.
Walking & dietary modification: 1. Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those whose jobs required them to seat for long periods should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, such as near term.
2. At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water, sugar-sweetened beverages or large amount of fruits. Sucralose could be used as a sweetener. Participants were recommended to use ondansetron for nausea and vomiting prevention

Gestational Diabetes Mellitus

Preeclampsia

Mothers Who Used Heparin for Nephrotic Range Proteinuria or Placental Insufficiency

Weight gain >13 kg for underweight, normal weight or overweight mothers and > 9 kg for obese mothers

Excessive Weight Gain

First-trimester Losses

Second and Third-trimester Losses

Live-born Children

Babies Born at Term

Appropriate-for-gestational Age Babies

Hypoglycemia was defined as any blood glucose concentration ≤ 40 mg/dL.

Neonates With Hypoglycemia

Overall Study

Dr. Silvia Hoirisch-Clapauch

The intervention was standardized by training of research staff and should begin when participants wish to conceive. Careful instructions about walking speed and diet will be given to participants assigned to W&D at enrollment and at each consultation.
Walking & dietary modification: 1. Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those whose jobs required them to seat for long periods should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, such as near term.
2. At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water, sugar-sweetened beverages or large amount of fruits. Sucralose could be used as a sweetener. Participants were recommended to use ondansetron for nausea and vomiting prevention

Recurrent Miscarriage

Daily walking at a moderate pace (4 km/h) > 40 min, 7/7. Those remaining seated most of the day should walk 25-30 min twice a day, avoiding >12 h of physical inactivity. Walking may be replaced by stationary bicycle rides or swimming when convenient, which often occurred near term and when the mother was obese.
At least two daily servings of protein-rich food (≥ 4 g/kg of meat, poultry, fish or eggs) per day. Avoidance of high-carbohydrate, low-fiber meals, such as snacks, candies, fiber-free juices, coconut water or sugar-sweetened beverages. Sucralose could be used as a sweetener. Participants are recommended to use ondansetron for nausea and vomiting prevention

Walking & dietary modification

Hospital Federal dos Servidores do Estado, Ministry of Health

Walking and Dietary Modification for Recurrent Early Miscarriages

Walking and Dietary Modification for Women With Consecutive Early Miscarriages: a Randomized Study

Silvia Hoirisch Clapauch

Principal Investigator

Hospital dos Servidores do Estado do Rio de Janeiro

Participants were not blinded, but visits of the two groups were scheduled so as to not coincide..

Subject will receive a phenylephrine infusion to prevent and to treat hypotension associated with spinal anesthesia

Subject will receive an ephedrine infusion to prevent and to treat hypotension associated with spinal anesthesia

Hypotension

Ephedrine concentration: 8 mg/mL. The infusion will be initiated immediately after completion of the spinal injection at a rate of 1 mL/min and continued for a minimum of 2 min after which the infusion will be stopped, continued or increased based on the SBP each minute. After each SBP measurement the infusion will be stopped if SBP > 80% baseline, and the infusion will be continued or restarted if the SBP is approximately equal to 80% baseline. The infusion will be increased by 1 mL/min if the SBP < 80% baseline. Each time there is hypotension the patient will receive a 1 mL IV bolus of the study solution and the infusion will be increased by 1 mL/min until delivery.

Phenylephrine concentration: 100 mcg/mL. The infusion will be initiated immediately after completion of the spinal injection at a rate of 1 mL/min and continued for a minimum of 2 min after which the infusion will be stopped, continued or increased based on the SBP each minute. After each SBP measurement the infusion will be stopped if SBP > 80% baseline, and the infusion will be continued or restarted if the SBP is approximately equal to 80% baseline. The infusion will be increased by 1 mL/min if the SBP < 80% baseline. Each time there is hypotension the patient will receive a 1 mL IV bolus of the study solution and the infusion will be increased by 1 mL/min until delivery.

placental insufficiency/illamående

Ephedrine and Phenylephrine for Spinal Hypotension

Walking and Dietary Modification for Recurrent Early Miscarriages

Phenylephrine in Spinal Anesthesia in Preeclamptic Patients

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