Prevalence, Factors Associated, and Adverse Maternal Outcomes of Spinal Induced Hypotension among Mothers Undergoing Caesarean Section at a Tertiary Hospital South-Western Uganda

Prevalence, Factors Associated, and Adverse Maternal Outcomes of Spinal Induced Hypotension among Mothers Undergoing Caesarean Section at a Tertiary Hospital South-Western Uganda | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence, Factors Associated, and Adverse Maternal Outcomes of Spinal Induced Hypotension among Mothers Undergoing Caesarean Section at a Tertiary Hospital South-Western Uganda Bruno Sserunkuuma, SAMUEL OLOWO, Leevan Tibaijuka, Racheal Alum, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8691495/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 17 You are reading this latest preprint version Abstract Background Hypotension after spinal anesthesia for caesarean section remains common and is a serious complication which may lead to serious outcomes like cardiac arrest, morbidity and mortality. The study aimed to determine the prevalence of, factors associated with, and adverse maternal outcomes of spinal-induced hypotension following caesarean section at Mbarara Regional Referral Hospital. Methods and Materials: A hospital based cross-sectional study at Mbarara Regional Referral Hospital for the period of August 2022 to October 2022 was conducted on 394 mothers who underwent spinal anaesthesia during caesarean section. Systematic random sampling was used where we enrolled each second woman who had been delivered by caesarean section under spinal anaesthesia. Participant socio-demographic, baseline clinical, obstetric characteristics, intraoperative data and anaesthetic characteristics were obtained from the participant’s medical record. The prevalence of spinal-induced hypotension was the proportion of women with spinal-induced hypotension. Logistic regression analysis was used to determine the factors associated with spinal-induced hypotension. The adverse maternal outcomes of spinal-induced hypotension were reported as proportions and frequencies. The level of significance was set at 5%. Results Participants had a mean age of 26.71 ± 5.7 years and most women were multigravid (II-IV). The prevalence of spinal-induced hypotension was 67.5% (95% CI 62.7–71.9). At multivariable logistic regression, having a spinal block height proximal to T6 [aOR 1.92 95% C.I (1.09–3.39), p = 0.024], being given intrathecal bupivacaine dose above 10mg [aOR 1.74 95% C.I (1.04–2.89), p = 0.034], emergency caesarean section [aOR 2.32 95% C.I (1.20–4.46), p = 0.012], and not receiving a prophylactic vasopressor [aOR 1.66 95% C.I (1.02–2.68), p = 0.039] were independently associated with Spinal-induced hypotension. Seven of our participants got high spinal. Conclusion The prevalence of spinal-induced hypotension among mothers undergoing caesarean section at MRRH is high. We recommend routine administration of prophylactic vasopressor during all caesarean sections and clinicians to recognize these factors associated with spinal induced hypotension. Prevalence Factors Adverse Maternal Outcomes Spinal Induced Hypotension Mothers Caesarean Section Mbarara Regional Referral Hospital Uganda Full Text Additional Declarations No competing interests reported. Supplementary Files Supportingdataset.zip Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 01 Apr, 2026 Reviews received at journal 24 Mar, 2026 Reviews received at journal 19 Mar, 2026 Reviews received at journal 17 Mar, 2026 Reviews received at journal 16 Mar, 2026 Reviews received at journal 12 Mar, 2026 Reviewers agreed at journal 11 Mar, 2026 Reviewers agreed at journal 08 Mar, 2026 Reviewers agreed at journal 04 Mar, 2026 Reviewers agreed at journal 04 Mar, 2026 Reviewers agreed at journal 02 Mar, 2026 Reviewers agreed at journal 28 Feb, 2026 Reviewers invited by journal 24 Feb, 2026 Editor assigned by journal 23 Feb, 2026 Editor invited by journal 02 Feb, 2026 Submission checks completed at journal 31 Jan, 2026 First submitted to journal 31 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8691495","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":596536175,"identity":"034e23ba-5df4-475e-9b3c-cf1169d60456","order_by":0,"name":"Bruno Sserunkuuma","email":"","orcid":"","institution":"Mbarara University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Bruno","middleName":"","lastName":"Sserunkuuma","suffix":""},{"id":596536176,"identity":"27b6620d-68b2-4248-9fcc-073e151d4325","order_by":1,"name":"SAMUEL 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Uganda","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-anesthesiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bane","sideBox":"Learn more about [BMC Anesthesiology](http://bmcanesthesiol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bane","title":"BMC Anesthesiology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Prevalence, Factors, Adverse Maternal Outcomes, Spinal Induced Hypotension Mothers, Caesarean Section, Mbarara Regional Referral Hospital, Uganda","lastPublishedDoi":"10.21203/rs.3.rs-8691495/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8691495/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHypotension after spinal anesthesia for caesarean section remains common and is a serious complication which may lead to serious outcomes like cardiac arrest, morbidity and mortality. The study aimed to determine the prevalence of, factors associated with, and adverse maternal outcomes of spinal-induced hypotension following caesarean section at Mbarara Regional Referral Hospital.\u003c/p\u003e\u003ch2\u003eMethods and Materials:\u003c/h2\u003e \u003cp\u003e A hospital based cross-sectional study at Mbarara Regional Referral Hospital for the period of August 2022 to October 2022 was conducted on 394 mothers who underwent spinal anaesthesia during caesarean section. Systematic random sampling was used where we enrolled each second woman who had been delivered by caesarean section under spinal anaesthesia. Participant socio-demographic, baseline clinical, obstetric characteristics, intraoperative data and anaesthetic characteristics were obtained from the participant\u0026rsquo;s medical record. The prevalence of spinal-induced hypotension was the proportion of women with spinal-induced hypotension. Logistic regression analysis was used to determine the factors associated with spinal-induced hypotension. The adverse maternal outcomes of spinal-induced hypotension were reported as proportions and frequencies. The level of significance was set at 5%.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eParticipants had a mean age of 26.71\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;5.7 years and most women were multigravid (II-IV). The prevalence of spinal-induced hypotension was 67.5% (95% CI 62.7\u0026ndash;71.9). At multivariable logistic regression, having a spinal block height proximal to T6 [aOR 1.92 95% C.I (1.09\u0026ndash;3.39), p\u0026thinsp;=\u0026thinsp;0.024], being given intrathecal bupivacaine dose above 10mg [aOR 1.74 95% C.I (1.04\u0026ndash;2.89), p\u0026thinsp;=\u0026thinsp;0.034], emergency caesarean section [aOR 2.32 95% C.I (1.20\u0026ndash;4.46), p\u0026thinsp;=\u0026thinsp;0.012], and not receiving a prophylactic vasopressor [aOR 1.66 95% C.I (1.02\u0026ndash;2.68), p\u0026thinsp;=\u0026thinsp;0.039] were independently associated with Spinal-induced hypotension. Seven of our participants got high spinal.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe prevalence of spinal-induced hypotension among mothers undergoing caesarean section at MRRH is high. We recommend routine administration of prophylactic vasopressor during all caesarean sections and clinicians to recognize these factors associated with spinal induced hypotension.\u003c/p\u003e","manuscriptTitle":"Prevalence, Factors Associated, and Adverse Maternal Outcomes of Spinal Induced Hypotension among Mothers Undergoing Caesarean Section at a Tertiary Hospital South-Western Uganda","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-26 19:28:16","doi":"10.21203/rs.3.rs-8691495/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-01T07:00:08+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-24T19:09:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-19T14:23:13+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-17T17:23:18+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-16T09:45:30+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-12T19:02:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"140215539905703777361244481687340275862","date":"2026-03-11T18:14:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263299319448333641554447597044735372677","date":"2026-03-08T09:04:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"120743397079982857039545487201182021776","date":"2026-03-05T03:57:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"70500526739709142109770152687681140850","date":"2026-03-04T12:03:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"39418695024644010097380164152745141846","date":"2026-03-02T18:13:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"33358671750085395307172771462298399337","date":"2026-02-28T07:35:13+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-24T15:59:16+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-23T07:24:23+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-02T08:35:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-31T10:45:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Anesthesiology","date":"2026-01-31T10:31:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-anesthesiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bane","sideBox":"Learn more about [BMC Anesthesiology](http://bmcanesthesiol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bane","title":"BMC Anesthesiology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ce4061d2-f94e-4f3f-a922-cc979020a7bc","owner":[],"postedDate":"February 26th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-06T09:39:36+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-26 19:28:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8691495","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8691495","identity":"rs-8691495","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}