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- Title
Role of IVC collapsibility index to predict post spinal hypotension in pregnant women undergoing caesarean section. An observational trial.
- Authors
SINGH, YUDHYAVIR; ANAND, RAHUL K.; GUPTA, STUTI; ROY CHOWDHURY, SUMIT; MAITRA, SOUVIK; BAIDYA, DALIM K.; SINGH, AKHIL K.
- Abstract
Background: Postspinal anesthesia hypotension (PSH) in pregnant women is common and may lead to poor maternal and fetal outcome. Fluid loading in pregnant women before spinal anesthesia to prevent hypotension is of limited ability. We hypothesized that those women who are hypovolemic before spinal anesthesia may be at risk of PSH and inferior vena cava collapsibility index (IVCCI) will be able to identify hypovolemic parturients. Methods: In this prospective observational study, n = 45 women undergoing elective lower segment cesarean section with singleton pregnancy were recruited and IVCCI in left lateral tilt (with wedge) and supine position (without wedge) were noted by M-mode ultrasound (USG) before spinal anesthesia. After spinal anesthesia, changes in blood pressure were noted till 15 min after spinal anesthesia. Results: USG measurements were obtained in 40 patients and 23 of 40 patients (57.5%) had at least one episode of hypotension. Area under the ROC curve of IVCCI with wedge to predict PSH was 0.46 (95% CI 0.27, 0.64) and best cut-of value was 25.64 with a sensitivity and specificity of 60.9% and 35.5%, respectively. Area under the ROC curve of IVCCI without wedge to predict PSH was 0.38 (95% CI 0.19, 0.56) and best cut-of value was 20.4 with a sensitivity and specificity of 69.6% and 23.5%, respectively. Conclusion: We conclude that IVCCI is not a predictor of PSH in pregnant women undergoing elective cesarean section.
- Subjects
PREGNANT women; CESAREAN section; VENA cava inferior; HYPOTENSION; SUPINE position; SPINAL anesthesia
- Publication
Saudi Journal of Anaesthesia, 2019, Vol 13, Issue 4, p312
- ISSN
1658-354X
- Publication type
Article
- DOI
10.4103/sja.SJA_27_19