Comparing elective and emergency caesarean section by using bioimpedance method

There are limited studies focusing on hemodynamic changes between elective and emergent C/S cases. We considered that a better understanding of the alterations and physiological reactions in both situations with non-invasive novel technologies might be useful in managing maternal and fetal sides.

In this prospective observational study, non-invasive hemodynamic changes were observed by using the whole-body impedance method using the NICaS™ device. CO, cardiac index (CI), stroke volume (SV), stroke index (SI), total peripheric resistance (TPR), and cardiac reserve (GGI) parameters were evaluated with a non-invasive method. Measurements were done initiating before surgery, 9 times of 5 min intervals.

All 95 patients finished the study. 47 cesarean sections were in the elective group, 48 were in the emergent group. SV in 4.5.6. time intervals were statistically increased in the elective group (p values: SvMl4: 0.025, SvMl5: 0.049, SvMl6: 0.044) (p < 0.05). SI in the second-time interval was statistically increased in the emergent group (p-value SI2: 0.047) (p < 0.05). SI in the 4th time interval was statistically increased in the elective group (p-value SI4: 0.047) (p < 0.05). CO measurements were not statistically different between groups in all time intervals for all comparisons. CI in the second time interval was statistically decreased in the elective group (p-value CI2: 0.012) (p < 0.05). GGI in the 4th time interval was statistically increased in the elective group (p-value GGI4: 0.035) (p < 0.05). TPRI in the second time interval was statistically increased in the elective group (p-value TPRI 2: 0.014) (p < 0.05).

Understanding normal hemodynamic values before, during, and after C/S is feasible and might help the clinician assess patients' cardiac performance with a reliable noninvasive technique. NICaS might be a reliable tool to evaluate patients' baseline values and diagnose complications earlier during the surgery.