Expert: Dr Ian Jackson - please note UK based - 2/22/2007

Question
Hello Ian, Thank you for your time!
I am scheduled to have a Caesarean Section with a Spinal Tap. I have low blood pressure...around 90/45 with this pregnancy, and I am worried that the Spinal tap will lower it even more during the op. What happens if my BP drops too low during the procedure? I am thinking this is dangerous, and was wondering if the BP can be stabilised before any major problems occur during the OP, and what is used to correct the BP values? Is there anything I should be doing now to try to raise it?
Thank you so much in advance!

Answer
Hi there Elle
A good question..
Basically your anaesthetist should discuss this with you beforehand. It just means that we have to look after you even more carefully!
You are right that the spinal anaesthetic can lower your blood pressure and we use various techniques to overcome this. One important thing will be positioning you so you are not lying flat on your back. This helps to stop the baby and your uterus pressing on the big blood vessels in your tummy especially the one taking blood back to your heart from your lower body. If this does happen you can drop your blood pressure - indeed many pregnant women find they cannot lie flat on their backs in late pregnancy because of this.
Each unit has a different technique of using drugs to keep your blood pressure up. Many in the UK are now using an infusion of a drug (phenylephrine) which is started just after the spinal is established. This infusion has made controlling a mothers blood pressure much easier than it used to be.
So - don't worry, discuss it with your anaesthetist and no you shouldn't be doing anything to try and raise it.
I am sure all will go well, best of luck
kind regards
Dr Ian Jackson