The effect of maternal fundal height and abdominal circumference on maternal blood pressure during cesarean delivery

Abstract

Background: cesarean delivery is the most common surgical procedure practiced in obstetrics. It is associated with hypotension that has maternal and fetal effects. Objective: This study aimed to determine the correlation between maternal and fetal measures (abdominal circumference, symphyseal fundal height, estimated fetal weight, and amniotic fluid volume) and intraoperative hypotension during cesarean delivery.Study design: This cross-sectional study was conducted at the Suez Canal University hospital operating theatre from May 2021 to January 2023. We recruited women undergoing elective or emergency cesarean delivery. Maternal and fetal measures were recorded, including abdominal circumference, symphyseal fundal height, fetal weight and amniotic fluid index. Baseline maternal blood pressure and heart rate were determined and repeated measures were done at 1, 5, 10, and 15 minutes of the spinal anesthesia. The dose of ephedrine and the occurrence of nausea/vomiting were recorded.Results: There was a marked decrease in the systolic, diastolic, and mean arterial BP at 5 minutes (P value < 0.001). Hypotension occurred in 69.4% participants. The abdominal circumference was significantly larger among women who developed hypotension (116.7± 12.5 vs 111.4 ± 10.5, P value 0.007). There was a positive correlation between the abdominal girth and the Ephedrine dose required at 5 minutes only (r= 0.246, P value 0.001). Conclusion: Maternal abdominal circumference was significantly larger with hypotensive patients and correlated with the ephedrine dose at 5 minutes only.