Maternal hypotension during elective cesarean section and short-term neonatal outcome

Objective: To investigate the extent and risk factors for hypotension among women undergoing elective cesarean section, and whether maternal hypotension has any impact on perinatal infant outcome. Study Design: Retrospective analysis of data on 919 mother-infant pairs after elective cesarean section that involved the use of regional anesthetic. Data collection included information on maternal blood pressure during the cesarean section procedure and any infant perinatal complications. Results: Nearly one-half of the mothers underwent a decrease in their mean arterial blood pressure by ≥30%. The risk factors for hypotension included preoperative hypertension, older age, type of spinal anesthesia, and a higher infant birthweight. A drop in the maternal mean arterial blood pressure exceeding 30% or even 50% compared with the preoperative value was not found to predict any perinatal complications. Conclusion: Despite a very high prevalence of maternal hypotension during cesarean sections, term infants tend to tolerate this placental blood perfusion challenge without any major sequel.