Analysis of Risk Factors for Intraoperative Hypotension in Cesarean Section and Poor Prognosis of Neonates

Retracted: Analysis of Risk Factors for Intraoperative Hypotension in Cesarean Section and Poor Prognosis of Neonates

[This retracts the article DOI: 10.1155/2022/2468114.].

Predictive Efficacy of the Perfusion Index for Hypotension following Spinal Anesthesia in Parturient Undergoing Elective Cesarean Section: A Systematic Review and Meta-Analysis

This meta-analysis assessed the predictive efficacy of perfusion index for hypotension following spinal anesthesia (SA) in parturients undergoing elective cesarean section (CS). Electronic databases, including Google Scholar, EMBASE, Cochrane Library, and MEDLINE, were searched from inception to June 2023. The primary outcome was the diagnostic accuracy of the perfusion index in predicting the probability of perioperative hypotension following SA. The review included 12 studies involving 2009 patients, published between 2017 and 2023. The pooled sensitivity and specificity were 0.81 (95% confidence interval (CI) = 0.72-0.87) and 0.75 (95% CI = 0.67-0.82), respectively. Additionally, the pooled area under the curve (AUC) was calculated as 0.84 (95% CI = 0.81-0.87), suggesting a moderate to good accuracy of the diagnostic test. Using Fagan's nomogram plot, the positive likelihood ratio (LR) and negative LR were found to be 3 and 0.26, respectively. The results demonstrated that the perfusion index exhibited an acceptable level of accuracy in predicting perioperative hypotension after spinal anesthesia in parturients undergoing elective CS. These findings highlight the potential value of incorporating a perfusion index as a useful tool for clinicians to integrate into routine clinical practice, which necessitates further large-scale studies for verification.

Incidence and Risk Factors of Spinal Anesthesia-Related Complications After an Elective Cesarean Section: A Retrospective Cohort Study

Introduction Neuraxial anesthetic techniques are the method of choice for cesarean section (CS) deliveries, and spinal anesthesia (SA) is the preferred technique. Although the use of SA has greatly improved the outcomes of CS deliveries, SA-related complications are still a matter of concern. The study's primary aim is to measure the incidence of SA complications after a CS, specifically hypotension, bradycardia, and prolonged recovery, as well as to identify the risk factors for these complications. Method The data of patients who had elective CS using SA from January 2019 to December 2020 was collected from a tertiary hospital in Jeddah, Saudi Arabia. The study design was a retrospective cohort study. The data collected included age, BMI, gestational age, comorbidities, the SA drug and dosage used, the site of the spinal puncture, and the patient's position during the spinal block. Also, the patient's blood pressure measurements, heart rate, and oxygen saturation levels were collected at baseline and at 5, 10, 15, and 20 minutes. SPSS was used for statistical analysis. Results The incidence of mild, moderate, and severe hypotension was 31.4%, 23.9%, and 30.1%, respectively. In addition, 15.1% of the patients experienced bradycardia, with 37.4% experiencing a prolonged recovery. Two factors were associated with hypotension, including BMI and the dosage of the SA, with a p-value of 0.008 and a p-value of 0.009, respectively. The site of the SA punctures equal to or lower than L2 was the only factor associated with bradycardia (p-value = 0.043). Conclusion The present study concludes that BMI and the dose of SA were the factors associated with SA-induced hypotension during a CS, and the site of the SA puncture equal to or lower than L2 was the only risk factor associated with spinal anesthesia-induced bradycardia.