Risk factors for supine hypotension syndrome after cesarean section and development of a prediction model in parturients
10.3760/cma.j.cn131073.20230707.01107
- VernacularTitle:产妇腰麻后发生仰卧位低血压综合征的危险因素及其预测模型
- Author:
Pengfei NIU
1
;
Mingyang SUN
;
Ningtao LI
;
Enqiang CHANG
;
Yongfeng ZHU
;
Jiaqiang ZHANG
;
Xiaoguo RUAN
Author Information
1. 河南省人民医院 郑州大学人民医院麻醉与围术期医学科，郑州 450003
- Keywords:
Cesarean section;
Anesthesia, spinal;
Hypotension syndrome;
Risk factors;
Forecasting
- From:
Chinese Journal of Anesthesiology
2023;43(11):1311-1315
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the risk factors for supine hypotension syndrome (SHS) after spinal anesthesia and establish a predictive model in parturients.Methods:The medical records from pregnant women undergoing elective cesarean section were retrospectively analyzed. According to the standard that SBP dropped by 30 mmHg or below 80 mmHg after spinal anesthesia, the parturients were divided into non-SHS group and SHS group. The general data from patients and difference of external iliac vein flow (ΔIVF) during postural changes before anesthesia were collected. The factors with statistically significant differences between groups were included in the logistic regression model, the risk factors were identified and the weighted score regression prediction model was established, and the receiver operating characteristic curve was drawn to evaluate the model.Results:There were 64 parturients developed SHS after spinal anesthesia, with an incidence of 54.7%. Logistic regression analysis showed that fetal abdominal circumference, amniotic fluid index, ΔIVF and consumption of norepinephrine were independent risk factors for SHS after spinal anesthesia. The area under the receiver operating characteristic curve was 0.983, 95% confidence interval was 0.968-0.999, the sensitivity was 90.6%, the specificity was 96.2%, and the Youden index was 0.868. The prediction model of the line chart was tested by Hosmer-Lemshow, P=0.984, and the C index visualized the line chart model was 0.983. Conclusions:Fetal abdominal circumference, amniotic fluid index, ΔIVF and consumption of norepinephrine are independent risk factors for SHS after spinal anesthesia in parturients, and the risk prediction model can effectively predict the occurrence of SHS after spinal anesthesia.
