Guro Grindheim

Publications (2)9.38 Total impact

• Source

  Available from: Leiv Arne Rosseland

  Article: Changes in Blood Pressure and Cardiac Output during Cesarean Delivery: The Effects of Oxytocin and Carbetocin Compared with Placebo.

  Leiv Arne Rosseland, Tor Hugo Hauge, Guro Grindheim, Audun Stubhaug, Eldrid Langesæter
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  ABSTRACT: BACKGROUND:: Little is known about maternal hemodynamics after Cesarean delivery. Uterine contractions may increase cardiac output. Oxytocin is the first-line treatment for uterine atony, although the effects of the long-acting oxytocin analogue carbetocin are comparable with that of oxytocin. The authors analyzed the effects of i.v. oxytocin 5 U, carbetocin 100 µg, and placebo on hemodynamics, uterine tone, adverse events, and blood loss after Cesarean delivery. METHODS:: This was a randomized, double-blinded, placebo-controlled, parallel-group comparison of carbetocin and oxytocin after elective Cesarean delivery of singletons under spinal anesthesia (n = 76). Continuously measured invasive systolic arterial pressure was the primary outcome measure. RESULTS:: The mean systolic arterial pressure decrease was 28 mmHg (95% CI, 22-34) after oxytocin and 26 mmHg (95% CI, 20-31) after carbetocin. The decrease was greatest after 80 (95% CI, 71-89) and 63 s (95% CI, 55-72), respectively (P = 0.006). The differences were nearly undetectable after 2.5 min, although the effect of carbetocin was slightly greater than placebo (P < 0.001). The group differences in systolic arterial pressure decreased over 5 min and were gone at 1 h. Heart rate and cardiac output increased in all three groups. Stroke volume increased after oxytocin and carbetocin but was unchanged after placebo. CONCLUSIONS:: The hemodynamic side effects of oxytocin 5 U and carbetocin 100 µg were comparable. The lack of an increase in stroke volume in the placebo group challenges the theory that uterine contraction causes autotransfusion of uterine blood, leading to an increase in preload.
  Anesthesiology 04/2013; · 5.36 Impact Factor
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  Available from: Leiv Arne Rosseland

  Article: Changes in blood pressure during healthy pregnancy: a longitudinal cohort study.

  Guro Grindheim, Mette-Elise Estensen, Eldrid Langesaeter, Leiv Arne Rosseland, Karin Toska
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  ABSTRACT: To study longitudinally changes in blood pressure (BP) and heart rate (HR) during healthy pregnancies and to evaluate the influence of parity, pregestational overweight, and excessive weight gain. A prospective longitudinal cohort study of 57 healthy white women with singleton pregnancies. BP and HR were measured repeatedly at gestational age 14-16 weeks, 22-24 weeks, 30-32 weeks, 36 weeks, and 6 months postpartum using both an oscillometric measurement device (Dinamap) and finger arterial pressure (Finometer PRO). SBP, DBP, and mean arterial pressure (MAP) reached a statistically significant trough at gestational age 22-24 weeks using both measurement devices. When compared with the nonpregnant measurement, SBP at gestational age 22-24 weeks was 6.2 mmHg [95% confidence interval (95% CI) 1.3-11.2] lower measured by Finometer and 7.2 mmHg (95% CI 4.2-10.1) lower measured by Dinamap. DBP and MAP were 8.9 mmHg (95% CI 4.6-13.2) and 9.8 mmHg (95% CI 5.3-14.2) lower measured by Finometer. Measured by Dinamap, DBP and MAP were 4.5 mmHg (95% CI 1.7-7.3) and 5.4 mmHg (95% CI 2.8-7.9) lower at gestational age 22-24 weeks when compared with the nonpregnant state. SBP was significantly higher in women with pregestational BMI at least 25 kg/m with both measurement devices (both P < 0.05). There were no differences in SBP, DBP, or MAP depending on parity or excessive weight gain. BP measured repeatedly by two different noninvasive devices during pregnancy and postpartum showed a statistically significant drop in mid-pregnancy, followed by a progressive increase until term.
  Journal of hypertension 12/2011; 30(2):342-50. · 4.02 Impact Factor