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Abstract

Fluid management is one of the cornerstones of patient
care, particularly during pregnancy & Caesarean
Section. Management of the volume state is vital for
maintaining adequate cardiac output, blood pressure
and oxygen delivery, with maintenance of tissue bed
and organ perfusion. In any critical illness this is
vital, but in pregnancy particularly so as to preserve
uteroplacental flow and placental perfusion. Unlike
many other tissue beds, the uteroplacental circulation
autoregulates poorly, leaving it reliant on maternal
cardiac output, blood pressure and metabolic
homeostasis in order to function correctly and avoid
fetal compromise. In addition, the pregnant woman
undergoes a number of physiological adaptations
in pregnancy that impact upon fluid management,
including an increase in the circulating volume and a
reduction in systemic vascular resistance.

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