Effects of fetal position on maternal hemodynamics after spinal anesthesia for cesarean delivery

Abstract

Background: Aortocaval compression by the gravid uterus is a known physiological phenomenon that is classically claimed to cause supine hypotension in full-term pregnant women. This study aimed to investigate the effects of fetal position on maternal hemodynamics after spinal anesthesia during cesarean delivery. Methods: In total, 71 women with intrauterine pregnancy over 36 weeks of gestation who were scheduled for elective cesarean delivery under spinal anesthesia were enrolled in the study. Based on the fetal position, the women were divided into two groups: right position group (group R) and left position group (group L). Occurrence of hypotension, requirement for rescue bolus injections of phenylephrine, and the total amount of infused phenylephrine before delivery were recorded in each group. Results: There was no statistically significant difference in the occurrence of hypotension between the two groups (P = 0.075); however, the amount of phenylephrine required before delivery was significantly greater in group R (P = 0.028). There was a statistically significant decrease in the systolic blood pressure compared with the baseline values in group R, and this change persisted until 15 min after spinal anesthesia. Conclusions: There was no difference according to fetal position in the number of patients who showed hypotension before delivery after spinal anesthesia.