Utilization of lower leg compression technique for reducing spinal induced hypotension, and related risks for mothers and neonates during cesarean delivery

Abstract

Background: Hypotension during spinal anesthesia for caesarean delivery is the most common clinical problem. It has a risk factor for adverse maternal and fetal events. This study aimed to evaluate the effect of the lower leg compression technique for reducing spinal induced hypotension risks for mothers and neonates during cesarean delivery. Methods: An experimental design was adopted in the current study. The study was conducted at the cesarean delivery unit in Benha University Hospital during the period from November 2013 to October 2014. A systematic random sample was detected according to the study formula based to be 768 of women underwent elective cesarean delivery with spinal anesthesia to be equally allocated into in two groups: leg compression and control group. Pre-hydration and anesthetic technique standardized protocol was followed. Hypotension was defined as a decrease in any mean arterial pressure (MAP) measurement by more than 20.0% of the baseline. Three tools were used in the current study to collect the necessary data: structured interviewing questionnaire sheet, maternal hemodynamic and signs of hypotension record, and neonatal outcomes assessment sheet. Results: A highly statistically significant difference was found between the leg compression and the control group regarding the mean arterial pressure and neonatal acidosis, as hypotension of the systolic arterial pressure, the diastolic arterial pressure, and the mean arterial pressure was affected a greater percentage of women at the control group than those in the leg compression. In addition neonatal Apgar scores were high among study leg compression group as compared with control group. Conclusions: The lower leg compression for women under elective cesarean with spinal anesthesia is an effective measure to reduce spinal induced hypotension during cesarean delivery. Recommendations: The lower leg compression during cesarean delivery should be included in the maternal hospitals protocol for reducing spinal induced hypertension and related risks for mothers and neonate during cesarean delivery.