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EP193 Risk factors of hypotension during cesarean section with spinal anesthesia in COVID-19 parturients: a retrospective study comparing with non-COVID-19 pregnant women
  1. Sung Jun Cho,
  2. Si Ra Bang and
  3. Gunn Hee Kim
  1. Department of anestheiology and pain medicine, National Medical Center, Seoul, Korea


Department of anestheiology and pain medicine, Inje University Seoul Paik Hospital, Seoul, Korea

Background and Aims The incidence of hypotension in pregnant women with COVID-19 undergoing regional anesthesia remains a controversial. The aim of this study is to investigate the incidence of hypotension during spinal anesthesia in pregnant women infected with COVID-19, as well as to identify associated risk factors.

Methods This retrospective study compared COVID-19-positive parturients who underwent cesarean section with spinal anesthesia between January 2021 and June 2022 (group COVID-19) with a control group of patients who underwent the same procedure between January 2017 and December 2021 and were statistically matched for age, weight, and height with the group COVID-19.

Results The COVID-19 group received low-dose bupivacaine anesthesia and showed comparable levels of anesthesia and blood pressure reduction to the control group. However, they required more colloid usage. A positive correlation was noted in the COVID-19 group between heart rate and hospital stay duration (p=0.000, Spearman’s rho= 0.422). Further analysis based on initial heart rate revealed that group H (100 or higher) had lower Apgar scores at 1 minute, longer hospital stays, and more severe COVID-19 symptoms. Moreover, in group H, there was a positive correlation between heart rate and the lowest systolic blood pressure after spinal anesthesia (p=0.012, Spearman’s rho=0.528).

Conclusions COVID-19 pregnant women have a higher risk of hypotension during cesarean section under spinal anesthesia compared to non-COVID-19. Given the close association between preoperative heart rate and the extent of hypotension in COVID-19 pregnant women undergoing spinal anesthesia, vigilant monitoring of vital sign by anesthesiologists is crucial during the perioperative period.

Abstract EP193 Table 1

Baseline characteristics of group COVID-19 and group control

Abstract EP193 Table 2

Perioperative anesthetic variables

Abstract EP193 Table 3

Subgroup analysis of group COVID-19 based on baseline heart rate


  • COVID-19
  • cesarean section
  • spinal anesthesia
  • hypotension

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