OBJECTIVETo study the effects of dopamine and phenylephrine for treatment of hypotension during cesarean section under combined spinal epidural anesthesia (CSEA) on the stereology of the placenta.

METHODSForty puerperants undergoing cesarean section under CSEA were randomly divided into dopamine group and phenylephrine group. Ropivacaine (16 mg) was administered immediately after spinal anethesia. Blood pressure was maintained near the baseline by adjusting the drug infusion rate. Fetal blood gas, Apgar score, and placental villus microvascular stereological changes were observed during the operation.

RESULTSThe microvascular density was significantly lower in dopamine group than in phenylephrine group (P<0.05). Phenylephrine group showed significantly lower umbilical artery blood pH than dopamine group (P<0.05). The Apgar score and blood pressure were comparable between the two groups (P>0.05). Compared to the baseline, both of the two groups showed significantly lowered heart rate during the operation (P<0.01).

CONCLUSIONDopamine is associated with the risk of fetal acidosis. Phenylephrine is helpful for preventing hypotension by increasing placental blood flow and improving oxygen supply to ensure maternal and fetal safety during cesarean section.

Amides ; administration & dosage ; Anesthesia, Spinal ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section ; Dopamine ; administration & dosage ; Female ; Fetal Blood ; Fetus ; Heart Rate ; Humans ; Hypotension ; drug therapy ; Infant, Newborn ; Oxygen ; Phenylephrine ; administration & dosage ; Placenta ; drug effects ; physiology ; Pregnancy ; Vasoconstrictor Agents ; administration & dosage