Title: Comparison of the Hemodynamic Changes in Normotensive and Severe Preeclamptic Pregnant Woman Posted for Cesarean Section under Subarachnoid Block
Authors: Dr Anupa Nanda Chowdhury, Dr Ashim Saikia, Dr Arbind Kr Ray, Dr Hrishikesh Bharali, Dr Trina Sen
DOI: https://dx.doi.org/10.18535/jmscr/v6i8.41
Abstract
Background: Anaesthetic approach to caesarean section in severely pre-eclamptic patients has considerably changed during the last few decades. Spinal anesthesia is widely regarded as a reasonable anesthetic option for cesarean delivery in severe preeclampsia, provided there is no indwelling epidural catheter or contraindication to neuraxial anesthesia. The aim of this study was to compare the haemodynamics between normal healthy parturients and patients with severe pre-eclampsia undergoing LSCS under spinal anaesthesia.
Materials and Methods: Spinal anesthesia was performed in two groups of parturients (31 in each group) with singleton pregnancy posted for elective LSCS. Heart rate and blood pressure were recorded before spinal anesthesia and thereafter at 3 minute intervals upto 60 minutes. Hypotension was defined as MAP <30% of the baseline or a decrease in SBP to < 100 mm Hg over the same time interval and was treated with 50 mcg phenylephrine i.v.
Results: The incidence rate of hypotension among the preeclamptic patients was lower than that of the healthy parturients (P <0.05). The total doses of IV Phenylephrine for treating hypotension were significantly lower among the preeclamptic patients (72 mcg in preeclamptic patients versus 188 mcg in normotensive patients) (P <0.05). There was no statistical difference in the neonatal outcome and APGAR score in the study groups.
Conclusion: Spinal anaesthesia in preeclampsia patients is associated with better perioperative hemodynamic stability, less hypotension and less vasopressor consumption.
Keywords: Preeclampsia, Cesarean, Anaesthesia, Spinal, Hypotension.
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