Incidence and Risk Factors of Post Spinal Hypotension Among Obstetrics Patients Undergoing Cesarean Section at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2024-06
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Addis Ababa University
Abstract
Background:Post spinal hypotension is defined as a decline in mean arterial pressure (MAP) of more than 20%
from baseline or systolic BP <90mmHG with in 20minutes of spinal anesthesia. Its prevalence
ranges from 30.1-71.5%.
Hypotension may pose serious risks like loss of consciousness and cardiac arrest on mothers undergoing
CS under spinal anesthesia.
Objective: To assess the incidence and risk factors of post-spinal hypotension among patients
undergoing cesarean section at Tikur Anbessa Specialized teaching Hospital, Addis Ababa,
Ethiopia.
Methodology: An institution-based prospective cross-sectional study was conducted using
262 obstetric patients admitted to TASH from November 2024 to May 2024. Data was entered
and cleaned and analyzed using SPSS version 26. Association between categorical variables was
determined using correlation logistic regression. Odds ratio was calculated on variables to
determine association through binary and multivariate logistic regression.
Those with P-value of 0.25 from binary logistic regression were brought to multivariable
analysis and independent variables with P-Value less than 0.05 was regarded as a risk factor for
Results: Among 262 patients, 157 (60%) AOR 0.6353, 95% CI 0.0438-1.213 had post spinal
hypotension following spinal anesthesia. Of which at 5% level of significance after multivariate
binary logistic regression analysis, the odds of developing post spinal hypotension for gravidity
<3 with P-value of 0.041 AOR 0.579, 95% CI (0.343-0.977), Supine patient position with P-
value of 0.004 AOR 2.149 with 95% CI (1.271-3.633), No Use of spinal additive with P-value of
0.008 AOR 0.456 with 95% CI (0.255-0.814).
Conclusion and recommendation:The incidence of hypotension to be 60% which shows that more than
half of mothers receiving spinal anesthesia are developing hypotension, which is a significant figure and
a big concern for safe modern anesthetic practice.
Although study on this particular area is sensitive and resource intensive, further multicenter
studies are needed to better understand these factors, for provision of safe anesthesia in modern
obstetric practice
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Keywords
Obstetrics Patients, Cesarean Section, Spinal Hypotension