Maternal Hemodynamics and Risk Correlation Following Spinal Anaesthesia for Cesarean Section: A Prospective Study in Bindura, Zimbabwe

Background: Spinal anaesthesia is the preferred anesthetic procedure for both elective and emergency cesarean sections in local Zimbabwean healthcare settings. However, post-spinal hypotension (PSH) remains a frequent and significant hemodynamic complication that can jeopardize maternal and neonatal well-being.

Objective: objective of present study was to investigate the incidence of PSH and evaluate the association between maternal anthropometrics, obstetric urgency, and sensory block height among parturients in the Bindura District, Zimbabwe.

Methodology: This study was conducted involving 150 parturients (ASA II) undergoing cesarean section under spinal anaesthesia at a provincial hospital in Mashonaland Central. Standardized anaesthesia was administered using 0.5% hyperbaric bupivacaine. We also monitored Hemodynamic parameters at 2-minute intervals for the first 10 minutes. Hypotension was defined as a  ≥ 20% drop in systolic blood pressure from baseline. Experimental data were analyzed using SPSS version 26, with p < 0.05 considered statistically significant.

Results: In present study, overall incidence of PSH was 61.3% (n=92). Significant independent predictors included a Body Mass Index (BMI)  ≥ 28 kg/m² (p < 0.01), a sensory block level ≥ T4 (p < 0.001), and emergency surgical status (p < 0.05). Emergency cases were demonstrated a significantly more precipitous hemodynamic decline, reaching a mean of 94.3 ± 14.5 mmHg at the 4-minute mark. Vasopressors were required in 77.2% of hypotensive cases, with Phenylephrine being the primary agent of choice.

Conclusion: At conclusion of our study, PSH is highly prevalent in the Bindura cohort, particularly in emergency and high-BMI patients. The "Emergency Gap" in stability suggests that proactive rather than reactive vasopressor protocols are essential for optimizing perioperative safety in regional Zimbabwean obstetric care.