Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia

Ashebir Nigussie Yirgu; Wosenyeleh Admasu Sahile; Abdurahman Tune Dedecho; Mohammed Suleiman Obsa; Zewde Zema Kanche

doi:doi:10.11648/j.cmr.20200904.13

| Peer-Reviewed

Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia

Ashebir Nigussie Yirgu, Wosenyeleh Admasu Sahile, Abdurahman Tune Dedecho, Mohammed Suleiman Obsa, Zewde Zema Kanche

Published in Clinical Medicine Research (Volume 9, Issue 4)

Received: 17 June 2020 Accepted: 21 July 2020 Published: 10 August 2020

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Introduction: Hypotension is a 20% to 30% reduction in baseline blood pressure. Infrequently, hypotension after spinal anesthesia can be significantly severe in pregnant mother and increases intraoperative and postoperative morbidity and mortality. Objectives: To assess magnitude and associated factors of post spinal hypotension among pregnant mothers who delivered by elective cesarean sections from January to February 2016 at Gandhi Memorial Hospital, Addis Ababa. Methods: Institution based cross sectional study design was conducted. All lists of pregnant mothers who gave birth by elective cesarean section under spinal anesthesia at Gandhi Memorial Hospital were included. Training was given for data collectors and supervisors. Regular supervision and follow up were made. Data was entered in to Epi info version 7 software and transported to SPSS version 20 for analysis. Odd ratio and 95% confidence interval was computed. Bivariate and Multivariate analysis used to identify factors associated with hypotension. Results: The study was conducted on 60 study participants. 24 (40%) were equally found between 25-29 years and 30-34 years. The incidence of hypotension was 80% during five to fifteen minute and 83% during fifteen to twenty five minute. 70% of the study participants were preloaded with more than 500ml of crystalloid and 60% were took oxytocin for uterine contraction. Majority of them were in supine position prior to spinal anesthesia. Conclusion and recommendation: The magnitude of post spinal hypotension was so high that the use vigorous fluid resuscitation and the use of prophylactic vasopressor were recommended.

Published in	Clinical Medicine Research (Volume 9, Issue 4)
DOI	10.11648/j.cmr.20200904.13
Page(s)	85-90
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Hypotension, Pre-loading, Spinal Anesthesia

References

[1]	Morgan PJ, Halpern SH, Tarshis J (2001) The effects of an increase of central blood volume before spinal anesthesia for cesarean delivery: a qualitative systematic review. Anesthesia & Analgesia 92: 997-1005.
[2]	Bajwa SJS, Bajwa SK, Kaur J, Singh A, Singh A, et al. (2012) Prevention of hypotension and prolongation of postoperative analgesia in emergency cesarean sections: A randomized study with intrathecal clonidine. International journal of critical illness and injury science 2: 63.
[3]	Macarthur A (2002) Solving the problem of spinal-induced hypotension in obstetric anesthesia. Canadian Journal of Anesthesia/Journal canadien d'anesthésie 49: 536-539.
[4]	Lee A, Kee WDN, Gin T (2002) A quantitative, systematic review of randomized controlled trials of ephedrine versus phenylephrine for the management of hypotension during spinal anesthesia for cesarean delivery. Anesthesia & Analgesia 94: 920-926.
[5]	Ueyama H, He Y-L, Tanigami H, Mashimo T, Yoshiya I (1999) Effects of crystalloid and colloid preload on blood volume in the parturient undergoing spinal anesthesia for elective Cesarean section. The Journal of the American Society of Anesthesiologists 91: 1571-1571.
[6]	Kee WDN (2010) Prevention of maternal hypotension after regional anaesthesia for caesarean section. Current Opinion in Anesthesiology 23: 304-309.
[7]	Ewaldsson CA, Hahn R (2001) Volume kinetics of Ringer’s solution during induction of spinal and general anaesthesia. British journal of anaesthesia 87: 406-414.
[8]	Obasuyi B, Fyneface-Ogan S, Mato C (2013) A comparison of the haemodynamic effects of lateral and sitting positions during induction of spinal anaesthesia for caesarean section. International journal of obstetric anesthesia 22: 124-128.
[9]	Loubert C, Hallworth S, Fernando R, Columb M, Patel N, et al. (2011) Does the baricity of bupivacaine influence intrathecal spread in the prolonged sitting position before elective cesarean delivery? A prospective randomized controlled study. Anesthesia & Analgesia 113: 811-817.
[10]	Simon L, Boulay G, Ziane A, Noblesse E, Mathiot J, et al. (2000) Effect of injection rate on hypotension associated with spinal anesthesia for cesarean section. International journal of obstetric anesthesia 9: 10-14.
[11]	Reidy J, Douglas J (2008) Vasopressors in obstetrics. Anesthesiology clinics 26: 75-88.
[12]	KlÖHR S, Roth R, Hofmann T, Rossaint R, Heesen M (2010) Definitions of hypotension after spinal anaesthesia for caesarean section: literature search and application to parturients. Acta Anaesthesiologica Scandinavica 54: 909-921.
[13]	Dahlgren G, Granath F, Wessel H, Irestedt L (2007) Prediction of hypotension during spinal anesthesia for cesarean section and its relation to the effect of crystalloid or colloid preload. International journal of obstetric anesthesia 16: 128-134.
[14]	Loubert C (2012) Fluid and vasopressor management for Cesarean delivery under spinal anesthesia: continuing professional development. Canadian Journal of Anesthesia/Journal canadien d'anesthésie: 1-16.
[15]	Banerjee A, Stocche RM, Angle P, Halpern SH (2010) Preload or coload for spinal anesthesia for elective Cesarean delivery: a meta-analysis. Canadian Journal of Anesthesia/Journal canadien d'anesthésie 57: 24-31.
[16]	Scrutton M (2004) Update in obstetric anaesthesia oxytocin: what dose and why. Anaesthesia Points West 37: 28-30.
[17]	Kinsella S (2003) Lateral tilt for pregnant women: why 15 degrees? Anaesthesia 58: 835-836.
[18]	Frölich MA, Caton D (2002) Baseline heart rate may predict hypotension after spinal anesthesia in prehydrated obstetrical patients. Canadian Journal of Anesthesia/Journal canadien d'anesthésie 49: 185-189.

Cite This Article

Plain Text BibTeX RIS

APA Style

Ashebir Nigussie Yirgu, Wosenyeleh Admasu Sahile, Abdurahman Tune Dedecho, Mohammed Suleiman Obsa, Zewde Zema Kanche. (2020). Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia. Clinical Medicine Research, 9(4), 85-90. https://doi.org/10.11648/j.cmr.20200904.13

Copy | Download

ACS Style

Ashebir Nigussie Yirgu; Wosenyeleh Admasu Sahile; Abdurahman Tune Dedecho; Mohammed Suleiman Obsa; Zewde Zema Kanche. Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia. Clin. Med. Res. 2020, 9(4), 85-90. doi: 10.11648/j.cmr.20200904.13

Copy | Download

AMA Style

Ashebir Nigussie Yirgu, Wosenyeleh Admasu Sahile, Abdurahman Tune Dedecho, Mohammed Suleiman Obsa, Zewde Zema Kanche. Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia. Clin Med Res. 2020;9(4):85-90. doi: 10.11648/j.cmr.20200904.13

Copy | Download

@article{10.11648/j.cmr.20200904.13,
  author = {Ashebir Nigussie Yirgu and Wosenyeleh Admasu Sahile and Abdurahman Tune Dedecho and Mohammed Suleiman Obsa and Zewde Zema Kanche},
  title = {Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia},
  journal = {Clinical Medicine Research},
  volume = {9},
  number = {4},
  pages = {85-90},
  doi = {10.11648/j.cmr.20200904.13},
  url = {https://doi.org/10.11648/j.cmr.20200904.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20200904.13},
  abstract = {Introduction: Hypotension is a 20% to 30% reduction in baseline blood pressure. Infrequently, hypotension after spinal anesthesia can be significantly severe in pregnant mother and increases intraoperative and postoperative morbidity and mortality. Objectives: To assess magnitude and associated factors of post spinal hypotension among pregnant mothers who delivered by elective cesarean sections from January to February 2016 at Gandhi Memorial Hospital, Addis Ababa. Methods: Institution based cross sectional study design was conducted. All lists of pregnant mothers who gave birth by elective cesarean section under spinal anesthesia at Gandhi Memorial Hospital were included. Training was given for data collectors and supervisors. Regular supervision and follow up were made. Data was entered in to Epi info version 7 software and transported to SPSS version 20 for analysis. Odd ratio and 95% confidence interval was computed. Bivariate and Multivariate analysis used to identify factors associated with hypotension. Results: The study was conducted on 60 study participants. 24 (40%) were equally found between 25-29 years and 30-34 years. The incidence of hypotension was 80% during five to fifteen minute and 83% during fifteen to twenty five minute. 70% of the study participants were preloaded with more than 500ml of crystalloid and 60% were took oxytocin for uterine contraction. Majority of them were in supine position prior to spinal anesthesia. Conclusion and recommendation: The magnitude of post spinal hypotension was so high that the use vigorous fluid resuscitation and the use of prophylactic vasopressor were recommended.},
 year = {2020}
}

Copy | Download

TY - JOUR
T1 - Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia
AU - Ashebir Nigussie Yirgu
AU - Wosenyeleh Admasu Sahile
AU - Abdurahman Tune Dedecho
AU - Mohammed Suleiman Obsa
AU - Zewde Zema Kanche
Y1 - 2020/08/10
PY - 2020
N1 - https://doi.org/10.11648/j.cmr.20200904.13
DO - 10.11648/j.cmr.20200904.13
T2 - Clinical Medicine Research
JF - Clinical Medicine Research
JO - Clinical Medicine Research
SP - 85
EP - 90
PB - Science Publishing Group
SN - 2326-9057
UR - https://doi.org/10.11648/j.cmr.20200904.13
AB - Introduction: Hypotension is a 20% to 30% reduction in baseline blood pressure. Infrequently, hypotension after spinal anesthesia can be significantly severe in pregnant mother and increases intraoperative and postoperative morbidity and mortality. Objectives: To assess magnitude and associated factors of post spinal hypotension among pregnant mothers who delivered by elective cesarean sections from January to February 2016 at Gandhi Memorial Hospital, Addis Ababa. Methods: Institution based cross sectional study design was conducted. All lists of pregnant mothers who gave birth by elective cesarean section under spinal anesthesia at Gandhi Memorial Hospital were included. Training was given for data collectors and supervisors. Regular supervision and follow up were made. Data was entered in to Epi info version 7 software and transported to SPSS version 20 for analysis. Odd ratio and 95% confidence interval was computed. Bivariate and Multivariate analysis used to identify factors associated with hypotension. Results: The study was conducted on 60 study participants. 24 (40%) were equally found between 25-29 years and 30-34 years. The incidence of hypotension was 80% during five to fifteen minute and 83% during fifteen to twenty five minute. 70% of the study participants were preloaded with more than 500ml of crystalloid and 60% were took oxytocin for uterine contraction. Majority of them were in supine position prior to spinal anesthesia. Conclusion and recommendation: The magnitude of post spinal hypotension was so high that the use vigorous fluid resuscitation and the use of prophylactic vasopressor were recommended.
VL - 9
IS - 4
ER -

Copy | Download

Author Information

Ashebir Nigussie Yirgu

Department of Anesthesia, Arsi University, Asella, Ethiopia
Wosenyeleh Admasu Sahile

Department of Anesthesia, Addis Ababa University, Addis Ababa, Ethiopia
Abdurahman Tune Dedecho

Department of Anesthesia, Arsi University, Asella, Ethiopia
Mohammed Suleiman Obsa

Department of Anesthesia, Wolaita Sodo University, Wolaita, Ethiopia
Zewde Zema Kanche

Department of Pharamcy, Wolaita Sodo University, Wolaita, Ethiopia

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Ashebir Nigussie Yirgu, Wosenyeleh Admasu Sahile, Abdurahman Tune Dedecho, Mohammed Suleiman Obsa, Zewde Zema Kanche. (2020). Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia. Clinical Medicine Research, 9(4), 85-90. https://doi.org/10.11648/j.cmr.20200904.13

Copy | Download

ACS Style

Ashebir Nigussie Yirgu; Wosenyeleh Admasu Sahile; Abdurahman Tune Dedecho; Mohammed Suleiman Obsa; Zewde Zema Kanche. Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia. Clin. Med. Res. 2020, 9(4), 85-90. doi: 10.11648/j.cmr.20200904.13

Copy | Download

AMA Style

Ashebir Nigussie Yirgu, Wosenyeleh Admasu Sahile, Abdurahman Tune Dedecho, Mohammed Suleiman Obsa, Zewde Zema Kanche. Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia. Clin Med Res. 2020;9(4):85-90. doi: 10.11648/j.cmr.20200904.13

Copy | Download

@article{10.11648/j.cmr.20200904.13,
  author = {Ashebir Nigussie Yirgu and Wosenyeleh Admasu Sahile and Abdurahman Tune Dedecho and Mohammed Suleiman Obsa and Zewde Zema Kanche},
  title = {Magnitude and Associated Factors of Post Spinal Hypotension Among Pregnant Mothers Who Delivered by Elective Caesarean Section at Gandhi Memorial Hospital, Addis Ababa, Ethiopia},
  journal = {Clinical Medicine Research},
  volume = {9},
  number = {4},
  pages = {85-90},
  doi = {10.11648/j.cmr.20200904.13},
  url = {https://doi.org/10.11648/j.cmr.20200904.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20200904.13},
  abstract = {Introduction: Hypotension is a 20% to 30% reduction in baseline blood pressure. Infrequently, hypotension after spinal anesthesia can be significantly severe in pregnant mother and increases intraoperative and postoperative morbidity and mortality. Objectives: To assess magnitude and associated factors of post spinal hypotension among pregnant mothers who delivered by elective cesarean sections from January to February 2016 at Gandhi Memorial Hospital, Addis Ababa. Methods: Institution based cross sectional study design was conducted. All lists of pregnant mothers who gave birth by elective cesarean section under spinal anesthesia at Gandhi Memorial Hospital were included. Training was given for data collectors and supervisors. Regular supervision and follow up were made. Data was entered in to Epi info version 7 software and transported to SPSS version 20 for analysis. Odd ratio and 95% confidence interval was computed. Bivariate and Multivariate analysis used to identify factors associated with hypotension. Results: The study was conducted on 60 study participants. 24 (40%) were equally found between 25-29 years and 30-34 years. The incidence of hypotension was 80% during five to fifteen minute and 83% during fifteen to twenty five minute. 70% of the study participants were preloaded with more than 500ml of crystalloid and 60% were took oxytocin for uterine contraction. Majority of them were in supine position prior to spinal anesthesia. Conclusion and recommendation: The magnitude of post spinal hypotension was so high that the use vigorous fluid resuscitation and the use of prophylactic vasopressor were recommended.},
 year = {2020}
}

Copy | Download