Epidural analgesia and autonomic hyperreflexia: a case report
Article Abstract:
Hyperreflexia, a neurologic condition marked by increased reflex reactions, is a potential problem for pregnant women with paraplegia, paralysis of the lower part of the body, including both legs. Hyperreflexia is caused by an increase in the release of the chemical catecholamine from the nerve cells. These surges of catecholamines can increase blood pressure and heart rate, producing symptoms of anxiety and panic. A 28-year-old paraplegic woman began prenatal care at 35 weeks of pregnancy when a severe ulcer on the base of her spine and a urinary tract infection developed. At 41 weeks of pregnancy a sensation of slight pressure was determined to be the onset of early labor. The patient's heart rate and blood pressure increased. The patient appeared sweaty and anxious. Epidural anesthesia, injected into the epidural space of the spine, was used to reduce the high blood pressure and anxiety. During delivery requiring forceps, hyperreflexia developed and labetalol, a drug to control high blood pressure, was given to decrease the patient's anxiety and normalize blood pressure. A healthy infant was delivered. The role of increased catecholamines is confirmed by the therapeutic response to the epidural anesthesia and labetalol. The second episode of hyperreflexia may have been avoided if the epidural anesthesia was given continuously. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1990
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Central hemodynamic effects of oxytocin and interaction with magnesium and pregnancy in the isolated perfused rat heart
Article Abstract:
Oxytocin therapy appears to affect heart circulation measurements similarly in both pregnant and non-pregnant rats. Some effects can be balanced by administering magnesium. Heart rate, left heart pressure, and the heart's ability to contract were analyzed after exposing the hearts of 15 pregnant and non-pregnant rats to increasing levels of oxytocin alone and then in combination with magnesium. Increases in oxytocin levels resulted in a corresponding increase in heart rate and decrease in contraction ability and left heart pressure. Magnesium therapy reversed the pressure and contraction changes.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1997
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