Incidence Of Supine Hypotension Syndrome In Patients Under Going Cesarean Section Under Spinal Anesthesia
DOI:
https://doi.org/10.66021/pakmcr1432Keywords:
Supine Hypotension Syndrome, Cesarean Section, Spinal Anesthesia, Maternal Hypotension, Obstetric Anesthesia, Maternal Hemodynamics, Aortocaval Compression, PregnancyAbstract
Background: Supine Hypotension Syndrome (SHS) is a common maternal complication during cesarean section under spinal anesthesia, resulting from compression of the inferior vena cava by the gravid uterus. This condition reduces venous return, leading to maternal hypotension and potentially adverse maternal and fetal outcomes. Identifying risk factors and implementing preventive measures are essential for improving perioperative care.
Objective: To determine the frequency of Supine Hypotension Syndrome and identify factors associated with its occurrence among women undergoing cesarean section under spinal anesthesia.
Methods: A descriptive cross-sectional study was conducted at Hayatabad Medical Complex, Peshawar, Pakistan, from April to August 2025. A total of 196 pregnant women undergoing elective or emergency cesarean section under spinal anesthesia were enrolled. Maternal demographic and clinical characteristics, including age, gestational age, body mass index (BMI), pre-existing hypertension, and use of left lateral tilt positioning, were recorded. The occurrence of SHS following spinal anesthesia was assessed, and associated risk factors were analyzed using multivariable logistic regression.
Results: Of the 196 participants, 42 (21.4%) developed SHS. The incidence was significantly higher among women with gestational age ≥36 weeks (p < 0.01) and BMI ≥30 kg/m² (p = 0.03). Left lateral tilt positioning effectively relieved SHS in 30 (71.4%) affected patients. Multivariable analysis identified obesity (BMI ≥30 kg/m²; OR = 2.3, 95% CI: 1.3–4.2) and gestational age ≥36 weeks (OR = 1.9, 95% CI: 1.1–3.5) as independent predictors of SHS. Overall, 15.3% of patients required vasopressor therapy for hypotension, with a significantly higher frequency among those who did not receive left lateral tilt positioning (p = 0.02).
Conclusion: Supine Hypotension Syndrome is a frequent complication during cesarean section under spinal anesthesia. Maternal obesity and advanced gestational age significantly increase the risk of SHS. Routine implementation of left lateral tilt positioning, along with appropriate fluid management and vigilant hemodynamic monitoring, may reduce the incidence and severity of SHS and improve maternal outcomes.
