article · East African Health Research Journal
Spinal anaesthesia is frequently used during caesarean sections but carries a substantial risk of maternal hypotension. An observational cross-sectional study of 300 patients undergoing caesarean delivery under spinal anaesthesia at Muhimbili National Hospital assessed the frequency of this complication and identified contributing factors. Over half of the cohort, 56.7 percent, experienced low blood pressure following anaesthesia administration. Most participants received hyperbaric bupivacaine, and two-thirds underwent emergency rather than elective procedures. The analysis showed that low volumes of intravenous fluid preload below 10 millilitres per kilogram, the absence of wedge positioning for uterine displacement, and higher sensory block levels were major risk factors. Implementing targeted preventive steps, such as sufficient fluid loading, correct patient positioning, and careful monitoring of sensory block extent, is critical to maintaining maternal stability.
Low blood pressure during caesarean delivery under spinal anaesthesia can threaten maternal and neonatal stability. Identifying specific clinical practices that increase this risk, such as inadequate fluid preloading or improper physical positioning, helps healthcare providers adjust standard operating protocols to safeguard mothers and babies during routine and emergency surgical procedures.
The abstract does not indicate an application pathway, as it focuses on clinical risk factor identification rather than product or technology development.
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Background: Spinal anaesthesia is a common regional technique for caesarean sections, but is associated with hypotension in up to 80% of patients. Preventive measures include; intravenous fluid preloading, left uterine displacement, compression stockings, and vasopressors. This study aimed to determine the prevalence and risk factors of hypotension during spinal anaesthesia in pregnant patients undergoing caesarean section at Muhimbili National hospital. Methods: A descriptive cross-sectional study was conducted at Muhimbili National Hospital's Obstetric theatre, involving patients who received spinal anaesthesia during caesarean section from August 2021 to January 2022. The study excluded patients with sedation, anti-hypertensive, pregnancy-induced hypertension, modified Bromage score, or combination anaesthesia. Data was collected, and analysed using SPSS version 20. Results: A total of 300 patients were enrolled (calculated sample size 270 plus 10% margin). Of these, 33.3% underwent elective caesarean section and 66.7% emergency caesarean section. Most patients (92%) received 0.5% hyperbaric bupivacaine, while 8% received 5% heavy lidocaine. Hypotension occurred in 56.7% of patients (95% CI: 0.511-0.623). Risk factors included preload <10 mL/kg, higher sensory block levels, and absence of wedge positioning. Conclusion: Hypotension during spinal anaesthesia for caesarean section is common. Preventive measures, including adequate fluid preload, wedge positioning, and careful monitoring of sensory block height, are essential to improve maternal hemodynamic stability.
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DOI: 10.24248/eahrj.v9i1.837
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