The Effect Of Stereological Study On Human Placenta And The Protein Of S100B In Cord Blood After Loading Different Colloids During Cesarean Section

Objectives:To observe the effects of volume expansion with different gelofusine to deal with the hypotension in cesarean section,and to discover the difference in umbilical cord blood,the concentration of the protein S100B in serum and the effect of placenta stereology after loading different gelofusine. The aim of study was to search for the volume which was best for the maternal and fetal.Methods:Singleton full-term pregnant women undergoing elective cesarean delivery were randomly allocated toⅠ,Ⅱ,Ⅲgroup (15 in each).Each pregnant received different gelofusine within 10 min before spinal anesthesia, groupⅠ(8ml/(kg.h)),groupⅡ(11 ml/(kg.h)),groupⅢ(15 ml/(kg.h)),and then gave them anethesia, maintain the volume expansion as the above speed until the baby delivery. With the patients in the left lateral position, spinal anesthesia was performed at the L2-3, and then gave 0.5% bupivacaine 1.6mL with the speed of 0.lml/s, and then patients were tilted to a 30°left lateral supine position, Oxygen was administered to all patients via nasal prongs at 2 L/min. Monitored and recorded the blood pressure and heart rate at eight time points which were before anesthesia (T0),after anesthesia lmin(T1),2min(T2),3min(T3),5min(T4),10min(T5),delivery time (T6) and operation over(T7). Meanwhile compare the Apgar scores of the new-borns at lmin and 5min, the umbilical arterial blood gas and the concentration of the protein S100B in serum.Observe the changes of the placental villous capillary by stereology method.Results:(1)The umbilical artery PaCO2, PaO2, PH, Apgar scores and the concentration of the protein S100B in serum were no significant differences in three groups(P>0.05).(2) The HR,SBP,MBP,DBP were no significant differences in three groups(P>0.05).(3) Comparision the HR,SBP at different time points in each group were significantly(P<0.05).(4) The length density of villous capillaries was insignificantly changed in three groups(P>0.05), while the volume density of villous capillaries in group I were significantly decreased than the group II and III (P<0.05).Conclusion:The major and medium volume expansion groups can maintain the pregnant women hemodynamics more stable than the small group during spinal anesthesia,to make more exchange between the maternal and fetal,to be more helpful to the maternal and fetal. But considered the maternal increased circulation volume in pregnancy, and the cardiac load was higher than non maternal,meanwhile there were no significance between the major and medium volume expansion groups,so we recommend that give the medium volume expansion for ten minutes before anesthesia until the baby was born woudl be best for the the maternal and fetal.