Key result
Pre-eclampsia was associated with a significantly lower incidence of spinal anesthesia-induced hypotension (30%) compared to non-preeclamptic parturients (58%) undergoing caesarean section.
Why the study?
The study was conducted to determine the incidence and magnitude of hemodynamic changes following subarachnoid block in patients with pre-eclampsia undergoing caesarean section.
Does pre-eclampsia alter the incidence and magnitude of hemodynamic changes after subarachnoid block in parturients undergoing caesarean section?
Observational (n=100)
No
Does pre-eclampsia alter the incidence and magnitude of hemodynamic changes after subarachnoid block in parturients undergoing caesarean section?
Pre-eclampsia parturients experience less incidence and magnitude of hypotension following subarachnoid block for caesarean section compared to non-preeclampsia parturients.
Answers are grounded in this paper and cite their sources.
Spinal anesthesia was associated with less hypotension in preeclamptic versus normotensive parturients; leaves open need for randomized trials before practice change.
Aim: The aim of this study is to determine the incidence and magnitude of hemodynamic changes after subarachnoid block in patients with pre-eclampsia undergoing caesarean section.Methods: A prospective observational study was conducted at LD Hospital SMHS GMC Srinagar, India, to determine the incidence of hypotension and the magnitude of hemodynamic changes following spinal anesthesia in pre-eclampsia and non-preeclampsia parturient who underwent caesarean section, from September 2018 to August 2019. 50 participants were enrolled in the pre-eclampsia group and 50 participants were enrolled in non-preeclampsia groups with a proportion of 1:1 ratios respectively. In the operation theatre, baseline hemodynamic variables (SBP, DBP, MAP, and HR) were recorded. The total intraoperative fluid consumption, total estimated blood loss, the weight of the new born were documented as well.Results: A total of 100 parturient were enrolled (50 non-preeclampsia and 50 pre-eclampsia parturient) in this study. The mean gestational age at the time of Caesarean section was significantly lower in the pre-eclampsia group: 38.36±1.53 weeks in non-preeclampsia versus 37.84±1.35 weeks in pre-ecliptics, p = 0.001 (Table 1). However, there was no statistically significant difference in the mean weight of the new born between groups; p = 0.37. The median upper sensory level at the time of skin incision was higher in the pre-eclampsia parturient compared to those with non-preeclampsia and this difference was statistically significant (T5 vs. T6; p = 0.029). Non-preeclampsia parturient received a higher volume of preload fluid compared with pre-ecliptics (613.99 ± 276.69 ml VS 559.76±322.78 ml; p = 0.003) and there was a statistically significant difference in intraoperative intravenous fluid consumption between groups, which was higher in non-preeclampsia compared to pre-eclampsia parturient (1718.87±345.79 vs 1487.63±421.77; p = 0.001).Conclusion: The incidence and magnitude of spinal anesthesia induced hypotension in parturient who underwent caesarean section were less in pre-ecliptics than in non-preeclampsia parturient.
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Benazir et al. (2021) conducted an observational in Pre-eclampsia (n=100). Pre-eclampsia vs. Non-preeclampsia was evaluated on Incidence of hypotension after spinal anesthesia (p=0.031). Pre-eclampsia was associated with a significantly lower incidence of spinal anesthesia-induced hypotension (30%) compared to non-preeclamptic parturients (58%) undergoing caesarean section.
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