377 Maternal obesity and hemodynamic adaptation to epidural anesthesia: evaluation using a novel non-invasive PPG-based sensor

Abstract

BMI influence maternal hemodynamics and adaptation during labor and delivery. We utilized an innovative, noninvasive, reflective PPG-based device (Biobeat Technologies Ltd.) that enables continuous monitoring to assess maternal obesity (BMI>30Kg/m2) impact on cardiovascular changes during labor and delivery. The Biobeat Monitoring Platform includes a wearable wristwatch monitor, that automatically samples cardiac output (CO), blood pressure (BP), stroke volume (SV), systemic vascular resistance (SVR) and heart rate (HR) every 5 seconds and uploads all data to a smartphone-based app and to a data cloud, enabling remote monitoring and analysis of data. Low risk parturients carrying term, singletons pregnancies were recruited at early delivery prior to active phase. Big data analysis was performed using the Power BI analysis tool (Microsoft). Data was normalized to visual presentation using Excel Data Analysis and regression tool. Average measurements were compared 20 minutes before and after epidural anesthesia and fetal delivery, stratified by maternal obesity. 81 parturients were recruited (age 30.2±5.2, years; 26 nullipara). Of them, 36 (44.4%) had BMI over 30 Kg/m2 (34.2±3.6 vs. 25.9±2.6, obese and non-obese, Kg/m2). Over 800,000 measurements were retrieved. Relative to the non-obese, obese parturients demonstrated stable MAP values following epidural anesthesia. This was most probably related to the relative increase in HR, SV and CO (Fig 1-2). There were no significant differences in hemodynamic adaptation to delivery between obese vs. non-obese parturients. Our study suggests that obese parturients are less prone to hypotension following epidural anesthesia.View Large Image Figure ViewerDownload Hi-res image Download (PPT)