Pulse rate monitoring before a C-section can improve maternal health

July 11, 2017

Doctors often prescribe preventative drugs to women who are to receive spinal blocks while giving birth via a Caesarean section. This is done to ensure that they do not experience a severe drop in blood pressure. Such preventative treatment against hypotension, however, can have side-effects, both for the mother and her baby. In a study in Springer's journal Annals of Biomedical Engineering, Augusto Navarro of the Miguel Servet University Hospital in Spain and collaborators investigate how clinicians can use aspects of pulse rate to decide whether blood pressure medication should be provided.

Most women undergoing a Caesarean section delivery tend to suffer from a hypotensive drop of about 20 percent in their blood pressure after receiving spinal anesthesia. It makes them dizzy or nauseous, and can even cause vomiting - to the extreme discomfort of the patient and the medical staff taking care of her. A blanket prescription of preventative medication has proved to be undesirable, because in some women it causes excessive high blood pressure. Unborn babies in turn could suffer oxygen deprivation (called hypoxia) or a build-up of acid in the blood (called acidosis).

To help clinicians decide whether and how much medication should be administered, Navarro and his team monitored the vital signs of 54 women who received preventative treatment, and 51 who did not. The women were waiting for an elective Caesarean section to be performed on them at a university hospital in Spain. An electrocardiogram sensor and a pulse photo plethysmograph sensor attached to a finger were used to record heart and pulse rate changes while the women were sitting or lying down.

Most women who did not receive preventative treatment developed hypotension. The research group therefore advises clinicians to focus on identifying patients whose blood pressure stays in the normal range, despite a spinal block and subsequent C-section. These patients are part of the outlying group who would not need any preventative medication.

Navarro's team recommend taking the levels of regularity and unpredictability in a woman's pulse rate variability into account when she moves from lying on her back to lying on her left side. In addition, measuring patient's pulse transit time while she was in different positions, as well as respiration rates, and specific personal details such as a woman's body mass index (BMI) provide clues as to whether the patient will develop hypotension.

"The combination of demographic data and features derived from electrocardiogram and pulse photo plethysmograph signals can lead to better classification results," says Navarro.
-end-
Reference: Bolea, J. et al (2017). Pulse rate and transit time analysis to predict hypotension events after spinal anesthesia during programmed Caesarean labor, Annals of Biomedical Engineering DOI: 10.1007/s10439-017-1864-y

Springer

Related Blood Pressure Articles from Brightsurf:

Children who take steroids at increased risk for diabetes, high blood pressure, blood clots
Children who take oral steroids to treat asthma or autoimmune diseases have an increased risk of diabetes, high blood pressure, and blood clots, according to Rutgers researchers.

High blood pressure treatment linked to less risk for drop in blood pressure upon standing
Treatment to lower blood pressure did not increase and may decrease the risk of extreme drops in blood pressure upon standing from a sitting position.

Changes in blood pressure control over 2 decades among US adults with high blood pressure
National survey data were used to examine how blood pressure control changed overall among U.S. adults with high blood pressure between 1999-2000 and 2017-2018 and by age, race, insurance type and access to health care.

Transient increase in blood pressure promotes some blood vessel growth
Blood vessels are the body's transportation system, carrying oxygen and nutrients to cells and whisking away waste.

Effect of reducing blood pressure medications on blood pressure control in older adults
Whether the amount of blood pressure medications taken by older adults could be reduced safely and without a significant change in short-term blood pressure control was the objective of this randomized clinical trial that included 534 adults 80 and older.

Brain blood flow sensor discovery could aid treatments for high blood pressure & dementia
A study led by researchers at UCL has discovered the mechanism that allows the brain to monitor its own blood supply, a finding in rats which may help to find new treatments for human conditions including hypertension (high blood pressure) and dementia.

Here's something that will raise your blood pressure
The apelin receptor (APJ) has been presumed to play an important role in the contraction of blood vessels involved in blood pressure regulation.

New strategy for treating high blood pressure
The key to treating blood pressure might lie in people who are 'resistant' to developing high blood pressure even when they eat high salt diets, shows new research published today in Experimental Physiology.

Arm cuff blood pressure measurements may fall short for predicting heart disease risk in some people with resistant high blood pressure
A measurement of central blood pressure in people with difficult-to-treat high blood pressure could help reduce risk of heart disease better than traditional arm cuff readings for some patients, according to preliminary research presented at the American Heart Association's Hypertension 2019 Scientific Sessions.

Heating pads may lower blood pressure in people with high blood pressure when lying down
In people with supine hypertension due to autonomic failure, a condition that increases blood pressure when lying down, overnight heat therapy significantly decreased systolic blood pressure compared to a placebo.

Read More: Blood Pressure News and Blood Pressure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.