Prediction of Hypotension During Cesarean Delivery Using Positional Change of Hemodynamic Parameters

This was a prospective observational study between January 2022 and June 2022. We included parturients aged 18 to 45 years, consenting, classified ASA II and III, scheduled for elective or emergency cesarean section (Lucas III-IV). Baseline hemodynamic parameters were measured in 3 different positions: sitting, supine, and left lateral tilt 15°. We defined Δ1 as the change from the sitting position to the supine position ad Δ2 as the change from the left lateral tilt 15° position to the supine position. Our primary endpoint was the incidence of hypotension defined as a decrease of more than 20% from baseline values. We performed univariate and then multivariate analysis.

Inclusion Criteria:American society of anesthesiologists' (ASA) physical status of II-III.Full-term pregnancy.Elective cesarean section.Emergency cesarean section (Lucas III-IV).Exclusion Criteria:Emergency cesarean section (Lucas I-II).Cesarean section under epidural anesthesia.Patients with abnormal placentation.Patients with contraindication for spinal anesthesia.Patients with personal medical history of cardiac arrythmias or valvular heart disease.Patients on beta-blockers.Failed spinal anesthesia.Conversion to general anesthesia.Postpartum hemorrhage.