International Journal of Clinical Obstetrics and Gynaecology

Background: Spinal anesthesia is the preferred technique for cesarean delivery; however, spinal anesthesia-induced hypotension remains a common concern. Traditionally, preeclamptic parturients were considered at higher risk of severe hypotension following neuraxial blockade. Emerging evidence suggests that altered vascular physiology in preeclampsia may result in a different hemodynamic response compared with normotensive parturients. Aim of the study was to compare maternal hemodynamic stability following spinal anesthesia for cesarean delivery in preeclamptic and normotensive parturients.
Materials and Methods: This prospective observational comparative study was conducted in the Departments of Anaesthesiology and Obstetrics & Gynaecology at Mamata Medical College, Khammam, over one year. Seventy-five parturients undergoing cesarean delivery under spinal anesthesia were divided into preeclamptic and normotensive groups. Baseline blood pressure was recorded as the average of two to three readings taken 3-5 minutes apart. Hemodynamic parameters (blood pressure, heart rate, and oxygen saturation) were recorded at predefined intraoperative and early postoperative time points. The incidence and magnitude of blood pressure changes were compared between groups.
Results: Baseline systolic, diastolic, and mean arterial pressures were significantly higher in the preeclamptic group. Although blood pressure decreased following spinal anesthesia in both groups, the decline was significantly greater in normotensive parturients, particularly during the first 10 minutes. Preeclamptic parturients demonstrated greater intraoperative hemodynamic stability with fewer hypotensive episodes and reduced need for corrective interventions.
Conclusion: Preeclamptic parturients undergoing cesarean delivery under spinal anesthesia exhibit greater hemodynamic stability than normotensive parturients despite higher baseline blood pressures. With vigilant monitoring and appropriate management, spinal anesthesia can be safely used in preeclamptic patients.