Comparing elective and emergency caesarean section by using bioimpedance method

Area of Science:

• Obstetrics and Gynecology
• Cardiovascular Physiology
• Medical Technology

Background:

• Limited research exists on hemodynamic variations between elective and emergent Cesarean sections (C/S).
• Understanding these physiological changes with novel non-invasive methods can aid maternal and fetal management.

Purpose of the Study:

• To prospectively observe and compare non-invasive hemodynamic changes in patients undergoing elective versus emergent C/S.
• To evaluate the utility of whole-body impedance method for monitoring cardiovascular parameters during C/S.

Main Methods:

• A prospective observational study involving 95 patients undergoing C/S.
• Non-invasive hemodynamic parameters including cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke index (SI), total peripheral resistance (TPR), and cardiac reserve (GGI) were measured using NICaS™.
• Measurements were taken at baseline and at nine 5-minute intervals during surgery.

Main Results:

• Stroke volume (SV) and stroke index (SI) showed statistically significant increases at specific intervals in the elective C/S group.
• The emergent C/S group exhibited a statistically significant increase in stroke index (SI) at one interval.
• Cardiac index (CI) decreased in the elective group at one interval, while total peripheral resistance (TPR) increased. Cardiac reserve (GGI) increased in the elective group at one interval.

Conclusions:

• Non-invasive hemodynamic monitoring is feasible for assessing cardiac performance before, during, and after C/S.
• The NICaS™ device may serve as a reliable tool for establishing baseline values and early detection of complications during C/S.