A three minutes supine position test reveals higher risk of spinal anesthesia induced hypotension during cesarean delivery. An observational study.

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SAP; systolic arterial pressure. Hb; hemoglobin concentration. BMI; body mass index. DAP; diastolic arterial pressure. MAP; mean arterial pressure. HR; heart rate. SV; stroke volume. CO; cardiac output. SVR; systemic vascular resistance Objectives Course Objective Cesarean delivery is performed under spinal anesthesia, and vasodilation is the main cause for a drop in blood pressure. The compression of the aorta and inferior vena cava by the gravid uterus is of additional clinical importance. Hypotension may occur during cesarean delivery even if prophylactic infusion of phenylephrine is practiced. We have tested if a 3 minute supine observation, can identify a subset of women with decreasing systolic arterial pressure (SAP) under spinal anesthesia.. We performed a prospective observational study at Oslo University Hospital on healthy pregnant women for planned cesarean delivery. Continuous measurements of calibrated invasive SAP and estimated cardiac output were recorded for 76 women in a 3 minutes measurement with the woman in the left lateral position, followed by supine position for 3 minutes. Using functional data clustering, principal component analysis and curve smoothing, to filter way noise and reduce the dimensionality of the signal, w...