A study for Pertinence in Emergent Cesarean Section / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to analyze the inclination, pertinence and influential factor in emergent cesarean section according to the assortment and analysis of the indication of emergent cesarean section. METHODS: The retrospective study was performed with the review of 360 emergent cesarean section cases from January 2003 to December 2003. RESULTS: The indication of cesarean section was followed by the order of progress failure (47.5%), previous cesarean section (19.2%), and fetal distress (15.8%). The improper operation of emergent cesarean section was done in fetal distress (28.1%), progress failure (8.6%), and induction failure (16.7%). The absence of acceleration with prolonged bradycardia was the most common (50.0%) type of fetal distress. The emergent cesarean section were done more commonly on Tuesday and Friday during weekdays and it was the peak time in a whole day of cesarean section from 11 o'clock to 12 o'clock and 16 o'clock to 17 o'clock. CONCLUSION: It was proved that twenty six (7.2%) cases of emergent cesarean section were done improperly. Now, work through the non-medical factors are considered more important to reduce improper section rate.

The Effect of Calcium Chloride on Hemodynamic Responses to Protamine Sulfate in the Dog / 대한마취과학회지

BACKGROUND: Protamine sulfate (PS), used to neutralize the effect of heparin, is often associated with systemic hypotension. The present study was aimed to investigate the protective effects of CaCl2 on adverse hemodynamic reaction to PS. METHODS: Forty-six dogs of three groups were studied. Animals were randomly allocated to receive either; saline 10 ml (controls, n = 26), CaCl2 5 mg/kg (n = 10) or 10 mg/kg (n = 10), added to PS 3 mg/kg given intravenously 5 min after heparin (300 IU/kg, iv). Mean aortic pressure (MAP), mean pulmonary arterial pressure (MPAP), left ventricular end-diastolic pressure (LVEDP), LVdP/dtmax, and -LVdP/dtmin, and pulmonary artery (cardiac output) and left circumflex blood flow (LCX flow) were recorded up to 15 min after PS. RESULTS: PS caused significant reductions in MAP (-49%), cardiac index (CI, -66%), systemic vascular resistance index (SVRI, -22%), LVEDP (-67%), LVdP/dtmax (-36%), and LVdP/dtmin (-55%), but increased MPAP (39%) and PVRI (3.8 fold), which all increases and reductions peaked 1-3 min after PS injection in the control group. The addition of CaCl2 to PS significantly attenuated reductions of MAP (-35 and -26% in CaCl2 5 and 10 mg/kg treated dogs, respectively), CI (-34 and -37%), LVdP/dtmax (-14, -11% ), and -LVdP/dtmin (-34, -21%), and increases in PVRI (1.8 and 2.4 fold). However, both doses of CaCl2 increased MPAP (48, 82%), but not SVRI (-28, -21%) or LVEDP (-73, -75%). LCX flow increased similarly in all groups (75-137%). CaCl2 5 and 10 mg/kg iv increased plasma Ca2+ by 0.23 and 0.36 mM, respectively. CONCLUSIONS: These results suggest that the simultaneous administration of CaCl2 attenuates the adverse hemodynamic effects of PS, used to reverse heparin anticoagulation in the dog.