Combined Colloids And Crystalloids Versus Crystalloids in Women With Preeclampsia Undergoing Cesarean Delivery

Performed at the L3-L4 or L4-L5 interspace using 27- or 25-gauge spinal needle

Bupivacaine 12.5 mg (2.5 mL 0.5%) will be administered in the subarachnoid space

Fentanyl 15 μg will be administered in the subarachnoid space

Lower segment cesarean section using the Pfannenstiel incision

The inferior vena cava largest and smallest diameters will be measured proximal to the opening of the hepatic veins in the longitudinal axis with the M-mode using a 8-2 MHz curved array ultrasound probe placed longitudinally in the subcostal region

6% hydroxyethyl starch 130/0.4 in 0.9% sodium chloride (voluven®) 250 mL will be administered over 5 minutes starting immediately after intrathecal injection

Ringer acetate 250 mL will be administered over 5 minutes starting immediately after intrathecal injection

Ringer acetate 500 mL will be administered over 55 minutes following colloid or crystalloid administration

After 60 minutes of intrathecal injection, 6% hydroxyethyl starch 130/0.4 in 0.9% sodium chloride (voluven®) 250 mL will be administered over 60 minutes

After 60 minutes of intrathecal injection, Ringer acetate 250 mL will be administered over 60 minutes

Intravenous ephedrine 3, 5, and 10 mg will be administered when Systolic blood pressure decreases below 120, 110, and 90 mmHg, respectively.

Immediately after delivery, syntocinon 10 IU will be added to the running crystalloid solution