A clinical comparative study of haemodynamic response between preeclampsia and normotensive parturients under spinal anaesthesia for cesarean section

Background: Haemodynamic adaptation in pre-eclampsia diverges from that in normotensive pregnancies and may predispose pre-eclamptic women to cardiopulmonary complications during pregnancy, at delivery and in early puerperium. This study Aimed to assess the efficacy of spinal anaesthesia for pregnant patients undergoing cesarean section, comparing the haemodynamic response between preeclampsia and normotensive parturients. Methods: A total of 60 patients were included in the study comprising of 30 patients in each group. The pregnant patients of more than 34 weeks of gestation, ASA Grade 1 and 2 and aged between 18 to 30 years undergoing elective caesarean section were included in the study. Results: There was no statistically significant difference observed with respect to demographic data, however When compared among study groups, it was noticed that mean Systolic BP, mean Diastolic BP and Mean Arterial Pressure was significantly higher in pre-eclampsic group as compared to normotensive group, which is as per the objective of the study. Patients were randomly allocated to one of the following study groups: Group I: Preeclampsic 0.5%, 2.5cc (12.5mg) Hyperbaric Bupivacaine group: 30 patient. Group II: Normotensive 0.5%, 2.5cc (12.5mg) Hyperbaric Bupivacaine group: 30 patients. The mean age of the study group was 25.17+3.61 years (mean+s.d.) and range = 18-30 years in the current study. The post operative ambulation motor block assessment using James Modified Bromage Scale showed mean difference between both groups was significant at 150 min after administration of the drug, with more pre-eclamptic patients being in stage 2. The mean VAS Scores was significantly higher in Preeclamptic subjects as compared to Normotensive subjects. We found significant differences in SBP, DBP and MAP at different point of times in both the groups. Conclusion: So in our study we can conclude that comparison of effect of subarachnoid block amongst pre eclampsia and normotensive group on hemodynamic parameters showed mean SBP mean DBP and mean arterial pressure to be significantly higher among pre eclampsia patients from baseline to 150 minutes after injection. However, the heart rate and SpO2 remained comparable in both the groups. The status of maximum block achieved and the mean time taken for it was also similar in both the groups. There was higher proportion of patients in normotensive group reported hypotension, nausea and vomiting.