RISK FACTORS OF SEVERE HYPOTENSION AFTER SPINAL ANESTHESIA DURING C-SECTION AT BACH MAI HOSPITAL

Đình Minh Tạ, Toàn Thắng Nguyễn, Hồng Đức Lê

Main Article Content

Abstract

Objects: Describe the characteristics of severe hypotension after spinal anesthesia during cesarean section and identify risk factors for this complication at Bach Mai Hospital. Methods: A prospective cohort study was conducted on 217 pregnant women undergoing spinal anesthesia for cesarean section at Bach Mai Hospital from May 2024 to August 2024. Results: 60.8% of pregnant women experienced severe hypotension. In the univariate analysis, there were 6 factors associated with severe hypotension: maternal age > 35 years, baseline systolic blood pressure ≥120 mmHg, speed injection, anesthesia site, block level, and intraoperative blood loss ≥500 ml. In multivariate regression analysis, age > 35 years, baseline systolic blood pressure ≥120 mmHg and speed injection were identified as 3 independent factors of severe hypotension. Conclusion: A study of 217 women undergoing spinal anesthesia for cesarean section showed that the rate of severe hypotension was 60.8%. Age over 35 years, baseline systolic blood pressure ≥120 mmHg, and drug injection rate were independent risk factors for severe hypotension after cesarean section anesthesia.

Article Details

References

Yirgu AN, Sahile WA, Dedecho AT, Obsa MS, Kanche ZZ. Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia. Clin Med Res. 2020;9(4):85. doi:10.11648/ j.cmr. 20200904.13
2. Maayan-Metzger A, Schushan-Eisen I, Todris L, Etchin A, Kuint J. Maternal hypotension during elective cesarean section and short-term neonatal outcome. AmJ Obstet Gynecol. 2010 Jan;202(1):56.e1-5. doi: 10.1016/ j.ajog.2009.07.012
3. Munyanziza T. Incidence of Spinal Anesthesia Induced Severe Hypotension among the Pregnant Women Undergoing Cesarean Section at Muhima Hospital. Rwanda J Med Health Sci. 2022;5(1):62-70. doi:10.4314/ rjmhs. v5i1.8
4. Wubie Birlie Chekol, Debas Yaregal Melesse, Abraham Tarekegn Mersha, Incidence and factors associated with hypotension in emergency patients that underwent cesarean section with spinal anaesthesia: Prospective observational study, International Journal of Surgery Open, Volume 35,2021,100378, ISSN 2405-857.
5. Fakherpour A, Ghaem H, Fattahi Z, Zaree S. Maternal and anaesthesia-related risk factors and incidence of spinal anaesthesia-induced hypotension in elective caesarean section: A multinomial logistic regression. Indian J Anaesth. 2018;62(1):36-46. doi:10.4103/ija.IJA_416_17
6. Kyokong O, Charuluxananan S, Sriprajittichai P, Poomseetong T, Naksin P. The incidence and risk factors of hypotension and bradycardia associated with spinal anesthesia. J Med Assoc Thai. 2006 Sep;89 Suppl 3:S58-64.
7. L. Simon, G. Boulay, A.F. Ziane, E. Noblesse, J.L. Mathiot, M.F. Toubas, J. Hamaza. Effect of injection rate on hypotension associated with spinal anesthesia for cesarean section, International Journal of Obstetric Anesthesia, Volume 9, Issue 1, 2000, Pages 10-14.
8. Bouchnak M, Belhadj N, Chaaoua T, Azaiez W, Hamdi M, Maghrebi H. Rachianesthésie pour césarienne: la vitesse d'injection a-t-elle une influence sur l'incidence de l'hypotension? [Spinal anaesthesia for Caesarean section: dose injection speed have an effect on the incidence of hypotension?]. Ann Fr Anesth Reanim. 2006 Jan;25(1):17-9. French. doi: 10.1016