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Spinal hypotension in obstetrics: Context-sensitive prevention and management
Dominique van Dyk1, Robert A Dyer1, David G Bishop2
1D23 Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Groote Schuur Hospital, Anzio Road, Observatory 7925, Cape Town, South Africa.
Best Practice & Research. Clinical Anaesthesiology
|June 6, 2022
Summary
Spinal hypotension during cesarean delivery is common, causing adverse outcomes. This review focuses on effective prevention and treatment strategies, especially for resource-limited settings.
Area of Science:
- Anesthesiology
- Obstetrics
- Global Health
Background:
- Spinal hypotension is a frequent complication during cesarean sections, leading to adverse maternal and fetal outcomes.
- Effective management strategies, including prophylactic vasopressors, are established in well-resourced settings.
Purpose of the Study:
- To review current best practices for preventing and treating spinal hypotension during cesarean delivery.
- To emphasize effective strategies applicable in resource-limited settings.
Main Methods:
- Literature review of current best practices.
- Analysis of strategies for resource-limited environments.
- Identification of research gaps.
Main Results:
- Prophylactic vasopressor administration is effective in well-resourced settings.
- Resource-limited settings face challenges with sophisticated strategies.
- Translational research shows promise for pragmatic, context-sensitive interventions.
Conclusions:
- Spinal hypotension remains a significant cause of maternal and fetal morbidity/mortality in resource-limited areas.
- Context-specific research is crucial for developing effective, low-resource strategies.
- Further research is needed to address knowledge gaps in diverse settings.
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