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Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
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Effect of postural changes on inferior vena cava dimensions and its influence on haemodynamics during caesarean

P Kundra1, G Arunsekar1, A Vasudevan1

  • 1a Department of Anaesthesiology & Critical Care , JIPMER , Puducherry , India.

Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology
|December 30, 2014
PubMed

The effect of postural changes on inferior vena cava (IVC) dimensions and its influence on intra-operative haemodynamics in term parturients can be studied using abdominal ultrasound by a subcostal approach. Thirty-two term parturients scheduled to undergo elective caesarean section under spinal anaesthesia were recruited in this observational study. End expiratory diameter and collapsibility index of IVC was measured preoperatively in 3 different positions - supine, recumbent with wedge and left lateral positions. End expiratory diameter was significantly high in recumbent (10.79) and left lateral (12.27) compared with supine (9.96) position (P < 0.0001). A greater fall in systolic blood pressure (>20%) was noted in patients with collapsibility index of more than 11.5 in recumbent with wedge position with a positive predictive value of 86%. IVC dimensions change significantly with change in position and collapsibility index in recumbent position can be a useful parameter for predicting hypotension during caesarean section under spinal anaesthesia.

Keywords:
caesareanhypotensioninferior vena cavaspinal

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