Comparison of efficacy of different physical methods in preventing severe hypotension in cesarean deliveries in supine hypotension syndrome

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Background Supine hypotension syndrome is a serious condition that can affect maternal and fetal morbidity during a cesarean delivery. We try to detect the effect of manual left uterine tilt on reducing the impacts of such syndrome. Patients and methods Ninety patients were randomly divided into three groups: manual displacement group (N=30), wedge group (N=30), and 15° table-tilt group. All parturients suffered from supine hypotension syndrome and were scheduled for cesarean section under subarachnoid anesthesia. The amount of fall in blood pressure, ephedrine consumption, induction delivery time, patient and surgeon satisfaction were all recorded. Results In the manual displacement group, the maximum drop in blood pressure and total ephedrine consumption were significantly lower than the wedge group and table-tilt group [20 (8.5), 27.8 (9.6), and 28.6 (8.5) mmHg, respectively, and 5 (1.5), 15.8 (3.6), and 16.4 (4.7) mg, respectively]. Also, patient and surgeon satisfaction was higher in the manual displacement group than the other two groups. Conclusion Manual uterine displacement is more effective than modified Crawford edge and 15° left table tilt in preventing severe hypotension in parturients with supine hypotension syndrome during a cesarean delivery with subarachnoid anesthesia with more patient and surgeon satisfaction.