Changes in Cardiac Output During Cesarean Delivery Under Spinal Anesthesia

Changes in Cardiac Output During Cesarean Delivery Under Spinal Anesthesia. A Prospective Observational Study Using Transthoracic Echocardiography

Cardiac output will be measured in healthy parturients undergoing cesarean delivery under spinal anesthesia

ASA-II women undergoing cesarean delivery under spinal anesthesia will be included. Cardiac output will be measured using transthoracic echocardiography at 4 time points: Baseline, after 10 minutes of intrathecal injection, after delivery, and after 1 hour of intrathecal injection. Spinal anesthesia will be administered with 2.5 ml bupivacaine 0.5% and fentanyl 15 μg.

Inclusion Criteria:

• American Society of Anesthesiologists physical status II parturients.
• Full term, singleton pregnancy
• Elective cesarean delivery under spinal anesthesia

Exclusion Criteria:

• Height <150 cm
• Weight <60 kg
• Body mass index (BMI) <18.5 or ≥ 35 kg/m²
• Women presenting in labor
• Contraindications to spinal anesthesia: increased intracranial pressure, coagulopathy, or local skin infection
• Hemoglobin <10 g/dL
• Current administration of vasoactive drugs (e.g., salbutamol, thyroxin)
• Diabetes mellitus, cardiovascular, or renal disease
• Chronic or pregnancy-induced hypertension
• Polyhydramnios
• Women with high risk for postpartum hemorrhage or uterine atony (e.g., placenta accreta spectrum, ≥3 previous cesarean deliveries)