• Yudhyavir Singh, Rahul K Anand, Stuti Gupta, Sumit Roy Chowdhury, Souvik Maitra, Dalim K Baidya, and Akhil K Singh.
• Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, New Delhi, India.
• Saudi J Anaesth. 2019 Oct 1; 13 (4): 312-317.

BackgroundPostspinal anesthesia hypotension (PSH) in pregnant women is common and may lead to poor maternal and fetal outcome. Fluid loading in pregnant women before spinal anesthesia to prevent hypotension is of limited ability. We hypothesized that those women who are hypovolemic before spinal anesthesia may be at risk of PSH and inferior vena cava collapsibility index (IVCCI) will be able to identify hypovolemic parturients.MethodsIn this prospective observational study, n = 45 women undergoing elective lower segment cesarean section with singleton pregnancy were recruited and IVCCI in left lateral tilt (with wedge) and supine position (without wedge) were noted by M-mode ultrasound (USG) before spinal anesthesia. After spinal anesthesia, changes in blood pressure were noted till 15 min after spinal anesthesia.ResultsUSG measurements were obtained in 40 patients and 23 of 40 patients (57.5%) had at least one episode of hypotension. Area under the ROC curve of IVCCI with wedge to predict PSH was 0.46 (95% CI 0.27, 0.64) and best cut-of value was 25.64 with a sensitivity and specificity of 60.9% and 35.5%, respectively. Area under the ROC curve of IVCCI without wedge to predict PSH was 0.38 (95% CI 0.19, 0.56) and best cut-of value was 20.4 with a sensitivity and specificity of 69.6% and 23.5%, respectively.ConclusionWe conclude that IVCCI is not a predictor of PSH in pregnant women undergoing elective cesarean section.Copyright: © 2019 Saudi Journal of Anesthesia.

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