Spinal Anaesthesia-Induced Hypotension in Lower Segment Caesarean Section: Predictors and Prevention - A Prospective Observational Study

Background: For lower segment caesarean sections (LSCS), spinal anaesthesia (SA) is the recommended anaesthetic method. Nonetheless, 50–80% of parturients experience spinal anesthesia-induced hypotension (SAIH), a serious complication that results in decreased placental perfusion and poor maternal-fetal outcomes. Goal: The goal is to develop a useful risk stratification strategy for clinical application by identifying independent predictors of spinal anesthesia-induced hypotension in parturients undergoing LSCS and assessing the effectiveness of various preventive strategies in various risk groups. Materials and Methods: Over the course of 18 months (January 2024 to June 2025), 286 women (ASA I–II, ages 18–45) undergoing LSCS under spinal anaesthesia participated in a prospective observational study. Clinical, haemodynamic, and demographic factors were methodically documented. Systolic blood pressure (SBP) of less than 90 mmHg, MAP of less than 65 mmHg, or a decrease of more than 20% from baseline were considered hypotension. To find independent predictors, univariate and multivariate logistic regression analyses were carried out. Preventive measures such as crystalloid preloading, positional modification, and vasopressor therapy were guided by risk stratification into low, moderate, and high-risk groups based on identified factors. Results: 18.5% of patients had severe hypotension (SBP