Abstract:
Background: The hemodynamic change is a common problem during cesarean section following
spinal anesthesia/SA/. The choice of anesthesia in the preeclamptic case is the main concern as
they are assumed at increased risk of hemodynamic changes. The hemodynamic changes compro-
mise fetal and maternal well-being if not managed immediately.
Objectives: To compare hemodynamic changes and vasopressor requirements after spinal anes-
thesia in preeclamptic and non-preeclamptic parturients during cesarean section in Jimma zone
public hospitals, Southwestern Ethiopia, from August 15- November 30, 2022.
Methods: The facility-based prospective cohort study was conducted on 126 parturients. The
study hospitals were selected by using simple random sampling and proportional sample sizes
were allocated to the hospitals. The Consecutive sampling technique was used. Symmetric data
were analyzed by an independent t-test, asymmetric data were analyzed by Mann-Whitney U-test,
and a chi-square test was used for categorical data. Hypotension was defined as a 20% drop in
SBP and HR changes were 20% (decrement or increment) of HR from the baseline value. The P-
value <0.05 was considered statistically significant.
Results: The incidence of hypotension after SA was higher in non-preeclamptic (50.8%) compared
to preeclamptic (31.7%). The SBP, DBP, and MAP were significantly higher in the preeclamptic
group thorough out intraoperative period (P<0.001). The maximum BP fall was significantly
higher in the non-preeclamptic compared with the preeclamptic group. The baseline and intraoper-
ative HR were comparable between the groups. The vasopressor requirements were significantly
higher in the non-preeclamptic as compared to preeclamptic(P=0.046). The majority of non-
preeclamptic developed hypotension within the first 15 minutes. However, the preeclamptic de-
veloped hypotension after 15 minutes following SA.
Conclusion and recommendation: The incidence of SA-induced hypotension, the magnitude of
BP fall, and vasopressor requirements were less in the preeclamptic group. The intraoperative HR
changes were comparable between the groups. The number of episodes of hypotension was higher
in the non-preeclamptic. The use of spinal anesthesia in preeclamptic is safe regarding the in-
traoperative hemodynamic changes for cesarean section if there are no other
