Serial transthoracic echocardiography for hemodynamic monitoring and early warning of hypotension during elective cesarean delivery: a prospective observational study
Authors' conclusion
Serial TTE monitoring detects a significant reduction in SV consistently before hypotension becomes clinically apparent, demonstrating the potential of TTE-derived parameters as physiological indicators of preload changes.
Study context
- Population
- Healthy term pregnant women (ASA I–II) undergoing elective cesarean delivery under spinal anaesthesia
- Participants
- 30 women
- Outcome
- Temporal relationship between SV decline and hypotension onset
Methodological detailssingle-centre, serial TTE at 13 predefined time points
- Single-centre
- Serial TTE at 13 predefined time points
Main finding
As reported in the abstract
SV decline vs hypotension onset · first post-spinal measurement
Stroke volume (SV) decrease at first post-spinal measurement
30.6%
SBP fall at first post-spinal measurement
12.2%
Observational data: associations, not effects.
Further findings
Haemodynamic changes after spinal anaesthesia
- End-diastolic volume (EDV) decrease
- 34.6%
- SV decrease
- 36.2%
- Cardiac output (CO) decrease
- 38.7%
- All P < 0.001
Hypotension (SBP drop > 20%)
- Incidence of hypotension
- 76.7%
Left ventricular ejection fraction (LVEF)
- Remained stable throughout
Recovery after fetal delivery
- All parameters partially recovered
Original publication
Serial transthoracic echocardiography for hemodynamic monitoring and early warning of hypotension during elective cesarean delivery: a prospective observational study. J Clin Monit Comput. Published 22 August 2026. doi:10.
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