RISK OF HYPOTENSION IN PREGNANT LADIES UNDERGOING SPINAL ANESTHESIA INDUCED CESAREAN SECTION DELIVERIES.

摘要

Background; Cesarean section, one of most commonly performed surgical procedure, is associated with significant increase in maternal morbidities as well as mortalities. Objective: To determine frequency of hypotension in normotensive and preeclemptia patients undergoing spinal anaesthesia induced cesarean section. Material and Methods; Spinal anaesthesia was employed following standard technique after aspiration of free flow of CSF from needle in all four quadrants. After induction of spinal anaesthesia continuous monitoring of heart rate, oxygen situation and blood pressure was done immediately and at regular intervals of 5,10,15,20,.25 and 30 minutes to diagnose hypotension. Results; Mean gestational age of our study cases was noted to be 39.23 ± 2.16 weeks and 101 (69.2%) had gestational age more than 38 weeks. Mean age of our study cases was 27.49 ± 2.93 years. Diabetes was presented in 19 (13 %) of our study cases. Status of blood pressure in pregnancy was also noted, 73 (50%) were normotensive and 73 (50%) were pre-eclamptic patients. Mean body mass index of our study cases was 26.23 ± 1.92 kg/m 2 and obesity was present in 43 (29.5 %) of our study cases. Of these 146 study cases, 44 (30.1 %) had elective cesarean section and 102 (69.9%) had emergency cesarean section. Hypotension was noted in 74 (50.7%) of our study cases. Hypotension was 35.6 % in normotensive cases while 65.8% among pre-eclamptic patients. Conclusion; Frequency of hypotension among women undergoing cesarean section with spinal anesthesia was high and hypotension was significantly more prevalent among women with the history of pre-eclampsia. Hypotension was significantly associated with age, residential status, monthly family income, diabetes, obesity and type of Cesarean section.