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Volume 15
Issue 22
10.3390/diagnostics15222846
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Article

Assessing Hemodynamic Changes During Locoregional Anesthesia in Cesarean Section: The Role of USCOM®

by
Agnese Lambertini
1,
Sara Doroldi
2,
Stefania Maria Mucci
1,
Silvia Porzio
1,
Fabio Caramelli
1,
Gianluigi Pilu
2 and
Elisa Montaguti
2,*
1
General and Pediatric Anesthesia and Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
2
Obstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy
*
Author to whom correspondence should be addressed.
Diagnostics 2025, 15(22), 2846; https://doi.org/10.3390/diagnostics15222846
Submission received: 16 October 2025 / Revised: 4 November 2025 / Accepted: 6 November 2025 / Published: 10 November 2025
(This article belongs to the Special Issue Insights into Perinatal Medicine and Fetal Medicine—2nd Edition)
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Abstract

Background: Locoregional anesthesia (LRA) during cesarean section (CS) is effective but frequently causes hypotension, affecting maternal hemodynamics and fetal outcomes. We investigated whether baseline hemodynamic characteristics predict post-LRA changes, vasopressor needs, and neonatal outcomes. Methods: Women undergoing elective CS with LRA were monitored with USCOM® (Ultrasonic Cardiac Output Monitor), recording cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke volume index (SVI), and systemic vascular resistance (SVR) every five minutes. Maternal demographics, vasopressor use, and neonatal outcomes were analyzed using multilevel linear regression. Results: LRA caused significant reductions in blood pressure and heart rate (p < 0.001). SV initially declined but recovered, while SVR showed minimal variation. Vasopressors were required in 63%, with choice guided by heart rate. Lower baseline SVI predicted greater vasopressor need (37.9 ± 6.7 vs. 34.5 ± 6.6, p = 0.050). Lower CO and CI before fetal extraction correlated with reduced neonatal pH, with CI significantly associated with pH < 7.20 (p = 0.043). Conclusions: USCOM® enables real-time, non-invasive monitoring, supporting individualized management during CS.
Keywords: USCOM; hemodynamic; cesarean; locoregional anesthesia; pregnancy USCOM; hemodynamic; cesarean; locoregional anesthesia; pregnancy

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MDPI and ACS Style

Lambertini, A.; Doroldi, S.; Mucci, S.M.; Porzio, S.; Caramelli, F.; Pilu, G.; Montaguti, E. Assessing Hemodynamic Changes During Locoregional Anesthesia in Cesarean Section: The Role of USCOM®. Diagnostics 2025, 15, 2846. https://doi.org/10.3390/diagnostics15222846

AMA Style

Lambertini A, Doroldi S, Mucci SM, Porzio S, Caramelli F, Pilu G, Montaguti E. Assessing Hemodynamic Changes During Locoregional Anesthesia in Cesarean Section: The Role of USCOM®. Diagnostics. 2025; 15(22):2846. https://doi.org/10.3390/diagnostics15222846

Chicago/Turabian Style

Lambertini, Agnese, Sara Doroldi, Stefania Maria Mucci, Silvia Porzio, Fabio Caramelli, Gianluigi Pilu, and Elisa Montaguti. 2025. "Assessing Hemodynamic Changes During Locoregional Anesthesia in Cesarean Section: The Role of USCOM®" Diagnostics 15, no. 22: 2846. https://doi.org/10.3390/diagnostics15222846

APA Style

Lambertini, A., Doroldi, S., Mucci, S. M., Porzio, S., Caramelli, F., Pilu, G., & Montaguti, E. (2025). Assessing Hemodynamic Changes During Locoregional Anesthesia in Cesarean Section: The Role of USCOM®. Diagnostics, 15(22), 2846. https://doi.org/10.3390/diagnostics15222846

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