Prevalence and Risk Factors of Hypotension in Patients Undergoing Cesarean Section with Spinal Anesthesia at Muhimbili National Hospital

Abstract

Introduction: Spinal anesthesia is a common regional anaesthesia for cesarean sections, causing 80% of patients to develop hypotension. Preventing hypotension involves intravenous fluid preloading, left uterine displacement, gravity, compression stocking, and vasopressors. This study aimed to determine the proportion of patients developing hypotension and the risk factors for hypotension during spinal anesthesia in pregnant patients undergoing cesarean 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 cesarean section from August 2021 to January 2022. The study excluded patients with sedation, anti-hypertensive, pregnancy-induced hypertension, modified Bromage score, or combination anesthesia. Data was collected, analyzed using SPSS version 20. Results: A study of 300 pregnant patients found that 33.3% of them underwent elective cesarean sections, while 66.7% experienced emergency cesarean sections. 92% received 0.5% hyperbaric Bupivacaine, while 8% received 5% heavy Lidocaine. Hypotension was the most common symptom during cesarean sections under spinal anaesthesia, with risk factors including preload of crystalloids less than 10 mls/kg and absence of wedge and sensory height block levels. Conclusion: Hypotension is a common complication in pregnant patients with spinal anesthesia, requiring proactive management strategies considering factors like local anesthetic choice, sensory block, and preload volume.