Department of Postgraduate, Changzhi Medical College, Changzhi, Shanxi, China.
Department of Anesthesiology, Jincheng General Hospital, Jincheng, Shanxi, China.
J Obstet Gynaecol Res. 2022 Dec;48(12):3103-3110. doi: 10.1111/jog.15420. Epub 2022 Sep 13.
The purpose of our study was to investigate the effect of the 15° left operating table tilt on the inferior vena cava (IVC) and the hemodynamics of full-term pregnant women, and to evaluate the efficacy of inferior vena cava collapse index (IVCCI) in predicting hypotension.
All parturients planning to perform cesarean section (CS) were randomly divided into supine group and 15° group. Their parameters of IVC were measured by ultrasound and then calculated the IVCCI. Systolic blood pressure (SBP), mean arterial pressure (MAP), and heart rate (HR) in two positions were recorded from baseline to fetal delivery.
The IVCCI in the 15° group was significantly lower when compared with that in the supine group (20.40 [18.84-21.60] vs. 21.82 [20.16-22.79] %, p = 0.012). The incidence of hypotension was observed statistically lower in the 15° group than the supine group (27.5% vs. 50%, p = 0.039). Best cut-off value was 21.69% and area under the receiver operating characteristic (ROC) curve of IVCCI in supine position to predict hypotension was 0.93. Best cut-off value was 21.78% and area under the ROC curve of IVCCI in supine position to predict hypotension was 0.80.
The 15° left operating table tilt can relieve the extent of compression of IVC and reduce the incidence of hypotension. IVCCI can predict the occurrence of hypotension.
本研究旨在探讨 15°左侧手术台倾斜对下腔静脉（IVC）和足月孕妇血流动力学的影响，并评估下腔静脉塌陷指数（IVCCI）预测低血压的效果。
所有计划行剖宫产（CS）的产妇均随机分为仰卧位组和 15°组。通过超声测量其 IVC 相关参数，并计算 IVCCI。记录两组产妇在基线至胎儿娩出期间的收缩压（SBP）、平均动脉压（MAP）和心率（HR）。
与仰卧位组相比，15°组的 IVCCI 显著降低（20.40[18.84-21.60]%比 21.82[20.16-22.79]%，p=0.012）。15°组低血压的发生率明显低于仰卧位组（27.5%比 50%，p=0.039）。仰卧位时 IVCCI 预测低血压的最佳截断值为 21.69%，ROC 曲线下面积为 0.93。仰卧位时 IVCCI 预测低血压的最佳截断值为 21.78%，ROC 曲线下面积为 0.80。
15°左侧手术台倾斜可减轻 IVC 的受压程度，降低低血压的发生率。IVCCI 可预测低血压的发生。
