Effect of Weight Gain During Pregnancy on Heart Rate Variability and Hypotension During Caesarean Section Under Spinal Anaesthesia

Ghabach, Maroun; El-Khatib, Mohamad; Zreik, TG; Matta, Andrea; Mouawad, JJ; Karam, CJ; Ayoub, CM

doi:10.1097/01.aoa.0000426126.02327.44

Cited by 7 publications

(8 citation statements)

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“…The results of our study are against the results of the study done by Ghabach MB et al, [5], Remart´ınez J et al, [6] and Ursulet, L et al, [7]. The purpose of this study was to assess the effect of antenatal weight gain on baseline heart rate variability and incidence of hypotension in singleton parturients with a normal pre-pregnancy body mass index, presenting at term for elective caesarean section under spinal anaesthesia.…”

Section: Discussionsupporting

confidence: 58%

Heart Rate Variability as A Predictor of Hypotension Following Spinal Anesthesia for Elective Caesarian Section in Preeclamptic Parturients: A Descriptive Observational Study

Shehata¹,

Sakka

Omran

et al. 2019

Open Access Maced J Med Sci

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AIM: In this study we aimed to find out the heart rate variability measuring using electrical cardiometry is not reliable as a predictor for hypotension following spinal anesthesia in preeclamptic parturients undergoing elective cesarean section. METHODS: Electrical Cardiometry system was used to measure Heart rate variability (HRV) at five different time points before fluid loading (T0, baseline), after fluid loading (T1), 5 min after spinal anaesthesia (T2), 15 min after spinal anaesthesia (T3) and 30 min after spinal anaesthesia (T4). Traditional HRV measurement was determined using time-domain analysis. This Observational descriptive cohort study was conducted in Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University from February 2018 till June 2019, after approval of the Ethical Committee and written patients consent. RESULTS: The main finding of the current study is that heart rate variability measuring using electrical cardiometry is not reliable as a predictor for hypotension following spinal anaesthesia in preeclamptic parturients undergoing elective cesarean section. CONCLUSION: Heart rate variability cannot be used as a predictor for hypotension following spinal anaesthesia in preeclamptic patients undergoing elective caesarean section using electrical cardiometry.

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Section: Discussionsupporting

confidence: 58%

Heart Rate Variability as A Predictor of Hypotension Following Spinal Anesthesia for Elective Caesarian Section in Preeclamptic Parturients: A Descriptive Observational Study

Shehata¹,

Sakka

Omran

et al. 2019

Open Access Maced J Med Sci

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“…Prediction of hypotension events during cesarean section would help to: 1) decrease the latency time between hypotension event and its treatment; 2) increase efficiency in the anesthetic administration to better control for the hemodynamic consequences of spinal block; 3) decrease the number needed to treat (NNT), thus avoiding unneeded pharmacological exposition and therefore reducing the derived sideeffects. Prediction of hypotension after spinal anesthesia during elective cesarean delivery has been reported in the literature 7,9,10,15,19,21,23,40,42 .…”

Section: Introductionmentioning

confidence: 99%

“…In our case, similar trend was found for the LF/HF ratio through the PTT signal (Hyp: 2.9±3.38 versus No-Hyp: 1.31±0.84 in LD-SD cohort and Hyp: 2.81±3.41 versus No-Hyp: 0.99±0.59 in LD-SD-SP cohort), see Table 2 and 3. Ghabach et al reported a relationshipbetween approximate entropy and antenatal weight gain15 . Assuming that this position was lateral decubitus, which represents the basal position without any extra hemodynamic stress, the results we found are in disagreement with the ones reported by Ghabach.…”

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confidence: 99%

Pulse Rate and Transit Time Analysis to Predict Hypotension Events After Spinal Anesthesia During Programmed Cesarean Labor

et al. 2017

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Prophylactic treatment has been proved to reduce hypotension incidence after spinal anesthesia during cesarean labor. However, the use of pharmacological prophylaxis could carry out undesirable side-effects on mother and fetus. Thus, the prediction of hypotension becomes an important challenge. Hypotension events are hypothesized to be related to a malfunctioning of autonomic nervous system (ANS) regulation of blood pressure. In this work, ANS responses to positional changes of 51 pregnant women programmed for a cesarean labor were explored for hypotension prediction. Lateral and supine decubitus, and sitting position were considered while electrocardiographic and pulse photoplethysmographic signals were recorded. Features based on heart rate variability, pulse rate variability (PRV) and pulse transit time (PTT) analysis were used in a logistic regression classifier. The results showed that PRV irregularity changes, assessed by approximate entropy, from supine to lateral decubitus, and standard deviation of PTT in supine decubitus were found as the combination of features that achieved the best classification results sensitivity of 76%, specificity of 70% and accuracy of 72%, being normotensive the positive class. Peripheral regulation and blood pressure changes, measured by PRV and PTT analysis, could help to predict hypotension events reducing prophylactic side-effects in the low-risk population.

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“…In contrast, a previous study found that weight gain <11 kg during gestation is a risk factor for hypotension triggered by spinal anesthesia (17) . Meanwhile, another study found that weight gain >11 kg during gestation is a risk factor for hypotension after spinal anesthesia (18) .…”

Section: Discussionmentioning

confidence: 71%

The Analysis of Risk Factors to Hypotension Occurring after Caesarean Spinal Anesthesia for Parturients with Scarred Uterus

Chen

Cao

Chen

et al. 2020

Preprint

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Background：This study examined the risk factors for hypotension after caesarean spinal anesthesia with low dose of bupivacaine and sulfentanyl in parturients with scarred uterus. Methods：A total of 322 singleton-pregnancy parturients with scarred uterus who had been scheduled for caesarean spinal anesthesia were randomly sampled. The data on the basic information of the parturients, the gestation, the fetus and the anesthesia were recorded and filed according to the clinical questionnaires on hypotension in caesarean section. The parturients whose systolic blood pressure dropped below 90 mmHg or decreased by 20% during the time from the completion of anesthesia until the delivery of infant were classified as Group hypotension (Group H) and the rest were in Group non-hypotension (Group N). This study analyzed the correlation of 39 factors to the occurrence of hypotension, and further analyzed the statistically significant factors through binary classification logistic regression.Results：Of the 322 sampled parturients, 148 parturients suffered hypotension. The incidence of hypotension in this study was 45.96%. The result of univariate analysis showed statistically significant differences in the factors including height (p=0.005), post-pregnancy Body Mass Index (BMI) (p=0.00), fasting time (p=0.031),weight gain in gestation (p=0.000), fundal height (p=0.047), exercise history in gestation (p=0.006) and dermatomal level of analgesia (p=0.000) between the two groups. The variables with statistical significance were analyzed by multivariate logistic regression model. The result showed that BMI in gestation (OR=1.146, 95% CI 1.041-1.262, p <0.05), weight gain in gestation (OR = 1.126, 95% CI 1.060-1.198, p <0.001), exercise history in gestation (OR = 0.399, 95% CI 0.205-0.778, p = 0.007), and dermatomal level of analgesia (OR = 2.248, 95% CI 1.645-3.074, p <0.001) were risk factors for hypotension after caesarean spinal anesthesia in parturients with scarred uterus. Conclusion：The incidence of hypotension after caesarean spinal anesthesia in parturients with scarred uterus was relatively high. The post-pregnancy BMI, weight gain in gestation, exercise history in gestation and dermatomal level of analgesia after anesthesia were risk factors for hypotension after caesarean spinal anesthesia in parturients with scarred uterus. These findings play an important role in predicting the occurrence of hypotension after caesarean spinal anesthesia in parturients with scarred uterus. Trial registration：Chinese Clinical Trial Registry (chiCTR-ROC-17011251)

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Effect of Weight Gain During Pregnancy on Heart Rate Variability and Hypotension During Caesarean Section Under Spinal Anaesthesia

Cited by 7 publications

References 0 publications

Heart Rate Variability as A Predictor of Hypotension Following Spinal Anesthesia for Elective Caesarian Section in Preeclamptic Parturients: A Descriptive Observational Study

Heart Rate Variability as A Predictor of Hypotension Following Spinal Anesthesia for Elective Caesarian Section in Preeclamptic Parturients: A Descriptive Observational Study

Pulse Rate and Transit Time Analysis to Predict Hypotension Events After Spinal Anesthesia During Programmed Cesarean Labor

The Analysis of Risk Factors to Hypotension Occurring after Caesarean Spinal Anesthesia for Parturients with Scarred Uterus

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