Abstract:
Abstract
Introduction: Spinal anesthesia induced maternal hypotension is the most frequent complication
associated with maternal morbidity and mortality during cesarean section. Hemodynamic
changes of parturients with preeclampsia are difficult to forecast. The aim of this study was to
compare the incidence and magnitude of hemodynamic changes in preeclamptic and nonpreeclamptic parturients undergone cesarean section under spinal anesthesia.
Method: A prospective cohort study was conducted from February to May 2019 in University of
Gondar comprehensive specialized hospital. A total of 122 ASA II and ASA III parturients were
recruited consecutively and assigned to two groups (81non-preeclamptics, and 41 preeclamptics).
The data analysis was done by SPSS version 22 statistical software. The data were tested for
normality with Shapiro Wilk U-test and normally distributed data were compared by using the
independent student’s t-test and expressed as mean ±SD. Whereas non-normally distributed data
were compared using the Mann-Whitney U- test and expressed as medians (IQR). Fisher’s exact
test was used for intergroup comparison of proportion. All P values <0.05 were considered
statistically significant.
Result: The incidence of spinal anesthesia-induced hypotension was higher in non-preeclamptic
parturients than preeclamptic parturients (55.6% vs. 34.1%, respectively) and the degree of blood
pressure drop was significantly greater in the non-preeclamptics parturients compared to those
with preeclamptics: 27.78% ± 5.44 vs. 21.05% ± 3.06 for SBP, 26.18% ± 4.07 vs. 23.93%± 4.79
for DBP, 25.65% ± 2.22 vs. 21.27% ±15.15 for MAP (p<0.001). As well intraoperative fluid
consumption was significantly greater in the non-preeclamptics parturients compared to those
with preeclamptics (1723.46ml ±352.41 versus 1463.41ml ±417.59; p= 0.001).
Conclusion and recommendation: The incidence and magnitude of spinal anesthesia-induced
hypotension in parturients undergone cesarean section were less in preeclamptic parturients than
in non-preeclamptic parturients. Therefore, don’t deny spinal anesthesia for preeclamptic
parturients due to fear of profound hypotension, unless there is contraindication for spinal
anesthesia.
