Effect of Abdominal Circumference and Fetal Weight on Supine Hypotension during C-Section under Spinal Anesthesia

Abstract

Background: Spinal anesthesia is the safest and most popular technique used for cesarean section worldwide. Certain maternal and fetal conditions such as increased maternal abdominal circumference and fetal weight can have profound effect on degree of hypotension cause by Spinal anesthesia. The study aims to determine the occurrence of spinal hypotension in relation to abdominal circumference and fetal weight.

Objective: To assess the relationship between term parturient’s abdominal circumference and the fetal weight with the occurrence of hypotension during cesarean delivery with spinal anesthesia.

Study type, settings & duration: This prospective observational study conducted at Department of Anesthesiology, Dr. Ruth K. M. Pfau Civil Hospital, Karachi from February to June 2022.   

Methodology: Total 116 terms parturient at 37 weeks or greater were enrolled after taking consent. The patient’s height and abdominal circumference in centimeters was measured using a measuring tape while weight was measured using a digital weighing scale. Two groups of patients were made according to the abdominal circumference. Baseline readings were taken of pulse, blood pressure and mean arterial pressure prior to the surgery. Patients were preloaded using crystalloids and then intra-thecal bupivacaine was administered, following the administration of spinal anesthesia mean arterial pressure, heart rate and blood pressure were recorded every three minutes till the delivery of the baby.

Results: Total 39 patients out of 116 developed hypotension. Out of these 39 patients 31 had an abdominal circumference of more than 101 cm. ..........