The article below summarizes a roundtable discussion of a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed:
Maayan-Metzger A, Schushan-Eisen I, Todris L, et al. Maternal hypotension during elective cesarean section and short-term neonatal outcome. Am J Obstet Gynecol 2010;202:56.e1-5.
The full discussion appears at www.AJOG.org , pages e12-e14.
Discussion Questions
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What were the objectives of the study?
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What were the study and control groups and what was the rationale for their definitions?
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What were the primary and secondary outcomes?
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How was sample size of the study determined?
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What are the key findings of the study?
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What are the strengths and limitations of the study?
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How generalizable are the findings of the study?
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Will this study change your practice?
A new study by Maayan-Metzger and colleagues reports the frequency and severity of maternal hypotension associated with regional anesthesia at the time of elective cesarean delivery. Data, collected from May 2006 to July 2007, are contemporary and are derived from a single large-volume hospital (Sheba Medical Center in Ramat-Gan, Israel) that has approximately 10,000 births per year. Of the 919 women who met the study criteria, 46.5% had a reduction in mean arterial blood pressure (MABP) of ≥30% during the cesarean section when compared with the preoperative measurement. A smaller percentage of women (7.6%) had a decrease of ≥50%. Despite these changes, there were no significant differences in any of the short-term neonatal outcomes reported (eg, respiratory distress or 1-minute Apgar) for the babies born to the women.
See related article, page 56
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