Femoral artery Doppler as a novel predictor of spinal hypotension in elective cesarean delivery cases: a prospective observational study
Authors' conclusion
Our findings in women undergoing scheduled cesarean delivery under spinal anesthesia and prophylactic norepinephrine infusion show that changes in the femoral artery Doppler indices, specifically pulsatility index, resistive index, and waveform morphology, may predict spinal hypotension.
Study context
- Population
- Pregnant women undergoing elective cesarean delivery under spinal anesthesia with co-load and prophylactic noradrenaline infusion13 with hypotension
- Participants
- 40 women
- Exposure
- Femoral artery Doppler indices for predicting spinal hypotension
- Outcome
- Accuracy of the change in pulsatility index in predicting spinal hypotension (SBP reduction >20 % of baseline)
Methodological detailsdiagnostic accuracy, ROC curve analysis
- Diagnostic accuracy
- ROC curve analysis
Main finding
As reported in the abstract
Prediction of spinal hypotension
| Group | AUC | Best cut-off |
|---|---|---|
| Change in pulsatility index | 0.99 (95% CI 0.90-1.00) | >10.6% |
| Change in resistive index | 0.96 (95% CI 0.85-1.00) | 12% |
AUC
Change in pulsatility index0.99 (95% CI 0.90-1.00)
Change in resistive index0.96 (95% CI 0.85-1.00)
Best cut-off
Change in pulsatility index>10.6%
Change in resistive index12%
Observational data: associations, not effects.
Further findings
Characteristics of patients with vs without hypotension
- Patients with hypotension showed higher baseline pulsatility index, shock index, change in pulsatility index, change in resistive index and change in waveform morphology
Absent waveform morphological changes after spinal anesthesia (rule-out)
- NPV for spinal hypotension
- 100%
Original publication
Femoral artery Doppler as a novel predictor of spinal hypotension in elective cesarean delivery cases: a prospective observational study. Int J Obstet Anesth. Published 18 June 2025. doi:10.
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