Maternal Hypotension Associated With Spinal Anesthesia During Cesarean Section
Conditions
Keywords
Spinal anesthesia, elective cesarean section, maternal hypotension, graduated compression stockings, leg elevation, randomized controlled trial
Brief summary
Aim: This study aimed to evaluate the effects of compression stockings and leg elevation on maternal intraoperative hypotension, vasopressor requirement, and neonatal well-being parameters in women undergoing elective cesarean section spinal anesthesia. Methods: This single-blind randomized controlled experimental study was conducted in the obstetrics service and operating room of Afşin State Hospital between November 1, 2023, and February 20, 2025. A total of 90 pregnant women who met the inclusion criteria were randomly assigned into three groups: the compression stockings group (n=30), the leg elevation group (n=30), and the control group (n=30). Spinal anesthesia was administered to all participants according to a standardized protocol. Maternal systolic, diastolic, and mean arterial blood pressure, as well as heart rate, were monitored at regular intervals during the intraoperative period. The occurrence of hypotension, vasopressor use, and side effects such as nausea and vomiting were recorded. Neonatal outcomes included the 5-minute APGAR score and umbilical venous blood gas parameters (pH and base excess). Data were analyzed using appropriate statistical methods. Results: Intraoperative systolic, diastolic, and mean arterial blood pressure values were significantly higher in both the compression stockings and leg elevation groups compared to the control group (p\<0.05). The rate of vasopressor use was significantly lower in both intervention groups compared to the control group (p\<0.05). There were no statistically significant differences among the groups in terms of neonatal APGAR scores, umbilical venous pH, and base excess values (p\>0.05). Conclusion: The use of compression stockings and leg elevation in women undergoing elective cesarean section تحت spinal anesthesia are effective, safe, and feasible non-pharmacological methods for maintaining maternal hemodynamic stability. These interventions reduce vasopressor requirements and hypotension-related side effects without adversely affecting short-term neonatal outcomes. The findings suggest that these methods can be integrated into clinical nursing practice for the prevention of spinal anesthesia-induced hypotension.
Interventions
DEVICEcompression stockings
a medical device that applies graduated pressure to the lower extremities to enhance venous return
OTHERLeg elevation
a positional intervention involving elevation of the lower extremities above the level of the heart to enhance venous return"
Sponsors
Seçil Yavaş
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Investigator)
Intervention model description
This study was designed as a single-blind, parallel-group randomized controlled trial.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
\- Inclusion Criteria: Gestational age between 37-40 weeks, Planned elective cesarean section, Maternal age between 19-40 years, Singleton pregnancy, Planned spinal anesthesia, Estimated fetal weight between 2500-4000 g.
Exclusion criteria
Known hypertensive disorders, History of severe lower extremity injury, History of deep vein thrombosis, Use of anticoagulant therapy, Placental invasion or placental localization abnormalities with a high risk of bleeding, Requirement for general anesthesia, Known fetal anomalies, Signs of acute or chronic fetal distress, Development of maternal complications during the operation. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maternal intraoperative hypotension | throughout the cesarean section | Maternal hypotension during spinal anesthesia |
| Maternal intraoperatif hipotansiyon | throughout the cesarean section | Maternal intraoperatif hipotansiyon |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORTülay Bülbül, doçent
Erciyes Üniversitesi
Outcome results
None listed