The study of maternal spinal anesthesia-induced hypotension during Cesarean section at Tu Du Maternal Hospital, Vietnam - the incidence and related risks

Abstract

Background and Aims: This study aimed to identify the incidence of spinal anesthesia (SA)-induced hypotension in those mothers who underwent cesarean section (CS) and evaluate associated factors (related to pregnant women, fetus, and operation process).

Methods: This cross-sectional study was conducted on 319 pregnant women between January and March 2022 at Tu Du Maternal Hospital, Ho Chi Minh City, Vietnam. The data were collected with the permission of candidates and then analyzed by using R program (4.4.1 edition). The multivariable logistic regression was done on related variables and p<0.05 was defined as the level of statistical significance.

Results: The incidence of SA-induced hypotension was 68.03%, in which blood pressure (BP) in about two-thirds of these cases (142/217) begins dropping in the first 10 minutes after anesthetic injection, and severe hypotension (defined as BP decreased more than 40% compared with the baseline BP) was found in 63/217 (29%) cases. The women aged ≥35 (OR 2.85, 95% CI: 1.57-5.47), height <155 cm (OR 2.15, 95% CI: 1.26-3.79), gravidity ≥3 (OR 3.20, 95% CI: 1.73-6.04), history of CS ≥2 (OR 6.71, 95% CI: 2.53-23.7), overweight (OR 3.43, 95% CI: 1.07-12.0) and baseline heart rate ≥90 beats/minute (OR 1.82, 95% CI: 1.13-2.94) were found to be associated with increased risk of hypotension.

Conclusions: The proportion of hypotension after spinal anesthesia for elective CS remained comparatively high, so the need of a comprehensive surgical preparation to minimize the negative impact of hypotension on those women and their children.