Heart rate variability and perioperative hypotension in gestational diabetes versus healthy parturients after subarachnoid block: A prospective observational study
M. Aishwarya, Partha Sarathi Mohapatra, Magna Manjarika, Amrita Panda, Sibanarayan RathIntroduction:
Subarachnoid block (SAB) is the anesthetic technique of choice for elective cesarean delivery owing to its rapid onset, reliability, and favorable maternal and neonatal outcomes. Gestational diabetes mellitus (GDM) has been associated with autonomic nervous system dysfunction, which may influence cardiovascular regulation during anesthesia. This study aimed to assess the predictive value of preoperative frequency-domain heart rate variability (HRV) parameters for post-spinal hypotension in parturients with and without GDM.
Materials and Methods:
In this observational study, 40 parturients undergoing elective cesarean section were enrolled, including 18 women with GDM and 22 healthy controls. Baseline HRV was assessed 1 day before surgery using a standardized 5-min electrocardiographic recording analyzed with Kubios HRV Premium software. Frequency-domain parameters, including low-frequency (LF) power, high-frequency (HF) power, and LF/HF ratio were calculated. Following SAB administration, hemodynamic variables were monitored throughout surgery and the immediate postoperative period. Hypotension was defined as systolic blood pressure below 80% of baseline. Statistical analysis was performed using SPSS version 26.0, with
Results:
Demographic characteristics were comparable between groups. No significant differences were observed in LF power, HF power, or LF/HF ratio between GDM and healthy parturients (
Conclusion:
Preoperative frequency-domain HRV parameters showed limited predictive value for post-spinal hypotension. Parturients with GDM demonstrated autonomic and hemodynamic responses similar to healthy controls, suggesting that these findings suggest that HRV frequency-domain analysis alone may have limited clinical utility as a screening tool.