HEMODYNAMIC VARIATIONS FOLLOWING SPINAL ANAESTHESIA IN NORMOTENSIVE VERSUS PREECLAMPTIC WOMEN UNDERGOING CAESAREAN SECTIONS: A COMPARATIVE ANALYSIS

Background: Preeclampsia significantly alters maternal hemodynamics and may influence responses to spinal anesthesia during cesarean delivery. Understanding these differences is crucial for optimizing anesthetic management and maternal safety. Methods: This prospective observational study compared hemodynamic responses to spinal anesthesia in 64 parturients (32 preeclamptic, 32 normotensive) undergoing elective cesarean sections at Lal Ded Hospital, Srinagar. Hemodynamic parameters including blood pressure, heart rate, and oxygen saturation were monitored at 12 time points over 120 minutes. Statistical analysis employed independent t-tests and chi-square tests. Results: Preeclamptic patients demonstrated significantly higher baseline blood pressure (SBP 162.53±14.65 vs 134.47±6.41 mmHg, p<0.001) but lower heart rate (99.34±13.92 vs 107.56±15.00 bpm, p=0.025). Following spinal anesthesia, preeclamptic women experienced more profound percentage decreases in blood pressure (SBP 47.7% vs 15.7%, DBP 51.3% vs 24.6%, MAP 49.9% vs 19.3%) with delayed nadir occurrence at 25 minutes versus 5 minutes. Vasopressor requirements were significantly higher in preeclamptic patients (84.4% vs 18.8%, p<0.001). Conclusion: Preeclamptic patients exhibit distinct hemodynamic responses to spinal anesthesia characterized by more pronounced blood pressure reductions, delayed nadirs, and increased vasopressor requirements despite elevated baseline vascular tone, necessitating individualized monitoring and management strategies.