Comparison of hemodynamic changes in normotensive and preeclamptic parturients undergoing cesarean section under spinal anesthesia: A prospective observational study

Abstract

Background and Aims: The safety of subarachnoid block (SAB) was established in preeclamptic parturients, but most of studies are of low quality. The study aimed to compare the hemodynamic parameters, phenylephrine requirement, and the neonatal outcome between normotensive and preeclamptic parturients undergoing cesarean section. Methods: This prospective observational study was conducted in 100 parturients, aged between 18 and 35 years, American Society of Anesthesiologists II/III scheduled for elective cesarean section under SAB. The heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) were recorded at the baseline, before SAB, and every 2 min till 30 min and then every 5 min till the end of the surgery. Phenylephrine was administered in a bolus of 50 μg when the MBP falls by 20% from the baseline. Neonatal outcomes were measured with the umbilical artery pH and APGAR scores at 1 and 5 min. The Statistical Package for the Social Science (SPSS) 26 was used for analysis. Results: The percentage fall in DBP and mean arterial BP from baseline was statistically significant between groups (26.83% ± 9.58% vs. 20.06% ± 14.17% and 24.90% ± 6.49% vs. 20.11% ± 9.75%). The mean requirement of phenylephrine was higher in the normotensive group than the preeclamptic (95.16 ± 41.54, 68.42 ± 31.14) (P < 0.001). The umbilical artery pH and APGAR scores at 1 and 5 min were comparable in both the groups. Conclusion: The incidence of hypotension was less in preeclamptic and required less phenylephrine compared to normotensives, with comparable neonatal parameters in parturients undergoing cesarean section under spinal anesthesia.

Keywords

• hypotension
• phenylephrine
• preeclamptic
• spinal anesthesia