An Increase in Prostacyclin Accompanies Reduction in Blood Pressure Following Peritoneal Closure in Patients Undergoing Cesarean Section

A prospective study in 50 parturients confirmed the clinical impression that peritoneal closure at cesarean section is frequently accompanied by falls in BP and rises in HR. Maximal changes were observed 5 ± 1 min after the start of closure, and recovery occurred within 20 min. Based on a report by Seltzer et al. (Anesthesiology 68, 1988), an association with prostacyclin (PGI2) was investigated. Arterial blood samples were obtained in 4 women undergoing elective cesarean section, before the epidural injection of 2% mepivacaine and at two different stages during peritoneal closure, for determination of plasma 6-keto-PGFioc, which is the stable breakdown product of PGI2. Striking increases in PGF1 concentration accompanied the reduction in BP; simultaneously, there developed erythema and/or flushing of face and palms.