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Hypotension due to spinal anesthesia influences fetal circulation in primary caesarean sections

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Hypotension due to spinal anesthesia is a well-known side effect in pregnant women receiving caesarean section. Little is known about its impact on fetal blood circulation.

Methods

40 women with uncomplicated singleton term pregnancies prepared for caesarean section were prospectively evaluated by Doppler sonography before and immediately after spinal anesthesia.

Results

In 90% of the women, blood pressure significantly decreased after spinal anesthesia and 42.5% of the patients suffered from severe hypotension. We found a significant negative correlation between maternal blood pressure change and the resistant index (RI) of the umbilical artery (rs = − 0.376, p = 0.017) and a significant positive correlation between maternal blood pressure and fetal middle cerebral artery.

Conclusion

Healthy fetuses seem to compensate well in situations with decreased uteroplacental blood flow due to maternal hypotension measured by means of RI changes in the fetal umbilical and middle cerebral artery. This raises the question if growth-restricted and/or preterm fetuses are able to compensate similarly or if general anesthesia would be a method of choice.

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Authors and Affiliations

Authors

Contributions

KL project development, data collection, investigation, data analysis, and manuscript writing. IB project development, data collection, investigation, data analysis, and manuscript writing. PW data collection, supervision and manuscript review. TWPF data analysis, statistical analysis, and manuscript review. WJ data analysis and manuscript review. FR data analysis and manuscript review. GF project development, data collection, manuscript writing, and manuscript review. UFH project development, data collection, and manuscript review.

Corresponding author

Correspondence to Peter Widschwendter.

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There was no funding for this study.

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Lato, K., Bekes, I., Widschwendter, P. et al. Hypotension due to spinal anesthesia influences fetal circulation in primary caesarean sections. Arch Gynecol Obstet 297, 667–674 (2018). https://doi.org/10.1007/s00404-017-4641-0

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  • DOI: https://doi.org/10.1007/s00404-017-4641-0

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