Role of Internal jugular vein(IJV) collapsibility index to predict post spinal hypotension in pregnant women undergoing cesarean section, a prospective observational study.

Internal jugular vein (IJV) is easier to access and there is limited data and study in the aspect of IJV collapsibility index as a predictor of post spinal hypotension, especially in pregnant women. This study is aimed at evaluation of IJV collapsibility index in assessment of post-spinal hypotension in caesarean section.

Patient fulfilling inclusion criteria will be explained about the procedure and after taking consent ,patient will be included in the study. Baseline hemodynamic parameters will be noted. Patient  will be subjected to ultrasonography of the right side of neck using linear probe ,the sonographic measurements of IJV will be assessed using M mode imaging and measurements such as  depth of IJV ,relation to carotid artery, maximum diameter (at end of expiration),minimum diameter(at end of inspiration),collapsibility index will be measured. The anaesthesiologist  performing ultrasonography will not be involved in intraoperative monitoring. Patient will recieve spinal anaesthesia and sensory level of T6 is targeted .And parameter such blood pressure (SBP,DBP,MAP),HR,RR,SpO2 will be noted every 3 minutes until delivery of the baby. The fall of MAP by 20% from baseline or <65 mmHg will be considered as hypotension. Hypotension will be treated with 6mg of mephentermine or 25mcg of phenylephrine intravenously. The study will finish with delivery of the baby& cord clamping. Data collection will be stopped and number of doses of vasopressor used to counteract hypotension will be noted.