PROGNOSTICATION OF ARTERIAL HYPOTENSION DEVELOPMENT CAUSED BY THE NEUROAXIAL BLOCK DURING THE CESAREAN
The aim of the research was studying of prognostic possibilities of arterial hypotension (AH) development caused by spinal anesthesia (SA) while performing a Cesarean, based on the assessment of cardiovascular system (CVS) reaction to the orthostasis and analysis of cardiac rhythm variability (CRV) at normal full-term pregnancy. 56 women of low-risk group were involved in the research. All of them were at 38-39 week of normally progressing pregnancy and had indications for a planned Cesarean. Prior to the operation, all the pregnants did an active orthostatic test (AOT) during the anesthesiologic examination when electrocardiogram (ECG) was nonstop registered. 5-minute ECG fragments, registered in both up and down positions, were used for the assessment of cardiac rhythm variability (CRV). All patients were divided into two subgroup according to their cardiovascular system (CVS) condition during the Cesarean while performing a neuroaxial block. The first subgroup consisted of 26 women with stable hemodynamics data during all the operation, and the second group consisted of 30 women who had arterial hypotension. The results of the analisis of cardiovascular system reaction to an active orthostatic test showed that high risk predictors of arterial hypotension development during the Cesarean while performing spinal anesthesia, were postural orthostat ic tachycardia or orthostatic hypotension in orthostasis, and also mush higher data of heart rate frequency and a stress-index registered in quiescent state while performing the analysis of cardiac rhythm variability. Thus, the assessment of CRV data and of the CVS reaction to orthostasis lets us estimate the possibility of arterial hypotension development during the Cesarean while performing a neuroaxial block, which can be used for preparation and carrying out of anesthesiologic help to the pregnant