{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:40:39Z","timestamp":1747183239201,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T00:00:00Z","timestamp":1597795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Intraabdominal pressure (IAP) is related to clinical outcome of patients. It is measured as intravesical pressure through a Foley catheter in the supine position. During pregnancy, there are data showing elevated IAP and also a suggestion that it may be a false increase due to pressure on the urinary bladder by the gravid uterus in the supine position. Additionally, it is not known whether the elevated IAP during pregnancy is merely a physiological change or is associated with impairment of organ functions. We thus aimed to establish a normal value of IAP in supine (IAP<jats:sub>supine<\/jats:sub>) as well as 10\u00b0 left lateral (IAP<jats:sub>lateral\u2010tilt<\/jats:sub>) positions, and their association with organ functions as well as certain maternal risk characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This prospective cross\u2010sectional cohort study included 100 consenting parturients with term gestation posted for elective cesarean section under single\u2010shot subarachnoid block. IAP was measured via an indwelling Foley catheter with a transducer connected to it, as per the recommended technique. Organ dysfunction was defined as Sequential Organ Failure Assessment (SOFA) subscore\u00a0\u22651 for the particular system. Trial registration: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ctri.gov.in\">ctri.gov.in<\/jats:ext-link> (CTRI\/2017\/11\/010527).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The IAP<jats:sub>supine<\/jats:sub> was significantly higher than IAP<jats:sub>lateral\u2010tilt<\/jats:sub> (13.8\u00a0\u00b1\u00a02.4 vs 12\u00a0\u00b1\u00a02.3\u00a0mm Hg) (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). The incidence of intraabdominal hypertension as per conventional definition, that is, IAP\u00a0\u226512\u00a0mm Hg, was also higher in the supine position (77% vs 55%) (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). None of the patients had dysfunction of the cardiovascular, renal or central nervous system. The incidence of respiratory, hepatic and hematologic dysfunction was 2%, 15% and 32%, respectively. Receiver operating characteristic analysis showed insignificant association of IAP<jats:sub>supine<\/jats:sub> and IAP<jats:sub>lateral\u2010tilt<\/jats:sub> with various organ dysfunctions (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a0.05). There was a significant correlation of intraabdominal hypertension when considering IAP<jats:sub>supine<\/jats:sub> or IAP<jats:sub>lateral\u2010tilt<\/jats:sub>, with obesity (<jats:italic>P\u00a0=\u00a0<\/jats:italic>.004 and .000, respectively), as well as preeclampsia (<jats:italic>P\u00a0=\u00a0<\/jats:italic>.006 and .000, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In nonlaboring patients undergoing elective cesarean section, IAP is significantly higher in the supine vs 10\u00b0 left lateral position. In neither position is IAP significantly associated with organ dysfunction. Thus, the usual recommendation of a supine position for measuring IAP to diagnose intraabdominal hypertension, formulated consequent to its pathological effects on organ functions, may not be applicable to pregnant patients and needs urgent validation studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13965","type":"journal-article","created":{"date-parts":[[2020,7,29]],"date-time":"2020-07-29T20:00:30Z","timestamp":1596052830000},"page":"101-108","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Intraabdominal pressure and its relation with organ dysfunction in patients scheduled for elective cesarean section: Effect of supine vs left lateral tilt position"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3728-0398","authenticated-orcid":false,"given":"Devansh","family":"Garg","sequence":"first","affiliation":[{"name":"Department of Anesthesiology &amp; Critical Care University College of Medical Sciences &amp; GTB Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5331-6832","authenticated-orcid":false,"given":"Asha","family":"Tyagi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology &amp; Critical Care University College of Medical Sciences &amp; GTB Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahendra","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology &amp; Critical Care University College of Medical Sciences &amp; GTB Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31817c7a4d"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00075198-200404000-00010"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000153408.09806.1B"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2906-z"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2011.10.010"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0077324"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0104782"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.02.055"},{"key":"e_1_2_9_10_1","first-page":"53","article-title":"Measurement of intraabdominal pressure in pregnant women at term","volume":"56","author":"Al\u2010Khan A","year":"2011","journal-title":"J Reprod Med"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13638"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050931"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.08.005"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13757"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2014.08.001"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13965","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.13965","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13965","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T03:29:58Z","timestamp":1693538998000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13965"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,19]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1111\/aogs.13965"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13965","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"type":"print","value":"0001-6349"},{"type":"electronic","value":"1600-0412"}],"subject":[],"published":{"date-parts":[[2020,8,19]]},"assertion":[{"value":"2020-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}