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Dergiler / Sakarya Tıp Dergisi / 2026 / Volume: 16 Issue: 1

Comparison of Colloid (Hydroxyethyl Starch) Preloading and Coloading for the Prevention of Hypotension During Cesarean Section Under Spinal Anesthesia: A Prospective Randomized Study

Hande Güngör(ISTANBUL MEDIPOL UNIVERSITY, SCHOOL OF MEDICINE)0000-0002-8920-1516
Filiz Gül(ISTANBUL MEDIPOL UNIVERSITY, SCHOOL OF MEDICINE)0000-0001-5158-6660
Tülin Esra Çırpıcı(LAPE FRENCH HOSPITAL, DEPARTMENT OF ANESTHESIOLOGY AND REANIMATION)0009-0002-5823-9703
Sayfa
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Yayın Tarihi
2026-03-28
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Conclusions: Colloid preload and coload administration were associated with comparable effects on maternal hypotension, vasopressor requirements, and neonatal outcomes in cesarean deliveries performed under spinal anesthesia.

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Amaç & Hipotez:Objective: This study aimed to compare the effects of hydroxyethyl starch (6% HES 130/0.4) administered as preload or coload on the incidence of maternal hypotension and neonatal outcomes in elective cesarean sections performed under spinal anesthesia.
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Temel Bulgular & Veri:Methods: This prospective, randomized trial included 162 parturients aged 18–45 years with American Society of Anesthesiologists physical status II and a gestational age greater than 36 weeks undergoing elective cesarean delivery under spinal anesthesia.
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Sonuç & Katkı:Conclusions: Colloid preload and coload administration were associated with comparable effects on maternal hypotension, vasopressor requirements, and neonatal outcomes in cesarean deliveries performed under spinal anesthesia.
🔬Tür:Research Article
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Cesarean section · Colloid · Coload

Abstract

Objective: This study aimed to compare the effects of hydroxyethyl starch (6% HES 130/0.4) administered as preload or coload on the incidence of maternal hypotension and neonatal outcomes in elective cesarean sections performed under spinal anesthesia. Methods: This prospective, randomized trial included 162 parturients aged 18–45 years with American Society of Anesthesiologists physical status II and a gestational age greater than 36 weeks undergoing elective cesarean delivery under spinal anesthesia. Participants received 500 mL of HES either 30 minutes before spinal anesthesia (preload group) or at the onset of cerebrospinal fluid flow (coload group). Maternal hemodynamic parameters were monitored throughout the procedure. Umbilical cord blood gas analysis, Apgar scores at 1 and 5 minutes, and total ephedrine consumption were recorded. Results: The incidence of maternal hypotension was 51.1% in the preload group and 48.9% in the coload group, with no statistically significant difference between groups (p = 0.83). Systolic arterial pressure at the onset of hypotension was 86.41 ± 8.63 mmHg in the preload group and 82.20 ± 9.14 mmHg in the coload group (p = 0.19). Total ephedrine requirement and umbilical cord blood gas parameters were comparable between groups. While 1-minute Apgar scores were similar, the 5-minute Apgar score was significantly higher in the preload group (p = 0.01). Conclusions: Colloid preload and coload administration were associated with comparable effects on maternal hypotension, vasopressor requirements, and neonatal outcomes in cesarean deliveries performed under spinal anesthesia.

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Bu Makaleye Atıf Yap

Güngör, H., Gül, F., Çırpıcı, T. E. (2026). Comparison of Colloid (Hydroxyethyl Starch) Preloading and Coloading for the Prevention of Hypotension During Cesarean Section Under Spinal Anesthesia: A Prospective Randomized Study. Sakarya Tıp Dergisi, Volume: 16 Issue: 1. https://doi.org/10.31832/smj.1791145

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Kaynakça (26)

  1. Sung TY, Jee YS, You HJ, Cho CK. Comparison of the effect of general and spinal anesthesia for elective cesarean section on maternal and fetal outcomes: a retrospective cohort study. Anesth Pain Med. 2021;16(1):49–55. doi:10.17085/apm.20072.
  2. Yu C, Gu J, Liao Z, Feng S. Prediction of spinal anesthesia-induced hypotension during elective cesarean section: a systematic review of prospective observational studies. Int J Obstet Anesth. 2021;47:103175. doi:10.1016/j.ijoa.2021.103175.
  3. Park HS, Choi WJ. Use of vasopressors to manage spinal anesthesia-induced hypotension during cesarean delivery. Anesth Pain Med. 2024;19(2):85–93. doi:10.17085/apm.24037.
  4. Sun L, Tang Y, Guo F, Liu J, Xu L, Zhu G, et al. Norepinephrine or phenylephrine for the prevention of post-spinal hypotension after caesarean section: a double-blinded, randomized, controlled study of fetal heart rate and fetal cardiac output. J Clin Anesth. 2024;97:111533. doi:10.1016/j.jclinane.2024.111533.
  5. Theodoraki K, Hadzilia S, Valsamidis D, Kalopita K, Stamatakis E. Colloid preload versus crystalloid coload in the setting of norepinephrine infusion during cesarean section: time and type of administered fluids do not matter. J Clin Med. 2023;12(4):1333. doi:10.3390/jcm12041333.
  6. Shang Y, Li H, Ma J, Tan L, Li S, Li P, et al. Colloid preloading versus crystalloid preloading to prevent hypotension after spinal anesthesia for cesarean delivery: a protocol for systematic review and meta-analysis. Medicine. 2021;100(7):e24607. doi:10.1097/MD.0000000000024607.
  7. Gong RS, Liu XW, Li WX, Zhao J. Effects of colloid preload on the incidence of hypotension in spinal anesthesia for cesarean section: a systematic review and meta-analysis. Chin Med J. 2021;134(9):1043–51. doi:10.1097/CM9.0000000000001477.
  8. Ni HF, Liu HY, Zhang J, Peng K, Ji FH. Crystalloid coload reduced the incidence of hypotension in spinal anesthesia for cesarean delivery, when compared to crystalloid preload: a meta-analysis. Biomed Res Int. 2017;2017:3462529. doi:10.1155/2017/3462529.
  9. Xu C, Zhang P, Dai C, Zhang J, Wu H, Liu Q, et al. Up-and-down determination of prophylactic norepinephrine boluses combined with crystalloid co-load for preventing post-spinal anesthesia hypotension during cesarean section. BMC Anesthesiol. 2025;25(1):38. doi:10.1186/s12871-025-02913-6.
  10. Noffsinger SR. Evidence-based prevention strategies for the management of spinal anesthesia-induced hypotension in healthy parturients undergoing elective cesarean delivery. AANA J. 2022;90(4):311–6. PMID: 35943759.
  11. Herbosa GAB, Tho NN, Gapay AA, Lorsomradee S, Thang CQ. Consensus on the Southeast Asian management of hypotension using vasopressors and adjunct modalities during cesarean section under spinal anesthesia. J Anesth Analg Crit Care. 2022;2(1):56. doi:10.1186/s44158-022-00084-1.
  12. Gao X, Huang Y, Hu S, Lin C, You Y, Huand S, et al. Effect of combined colloid preloading and crystalloid coloading versus combined colloid and crystalloid coloading on maternal cardiac output during spinal anesthesia for cesarean section under combined prophylactic noradrenaline infusion. Front Med. 2025;12:1421947. doi:10.3389/fmed.2025.1421947.
  13. Decuyper N, Van De Velde M. Fluid co-loading or preloading for the prevention of hypotension during spinal anesthesia for C-section: a narrative review. Acta Anaesthesiol Belg. 2023;74(2):113–21. doi:10.56126/74.1.09.
  14. Kaufner L, Karekla A, Henkelmann A, Welfle S, von Weizsäcker K, Hellmeyer L, et al. Crystalloid coloading vs. colloid coloading in elective caesarean section: postspinal hypotension and vasopressor consumption, a prospective, observational clinical trial. J Anesth. 2019;33(1):40–9. doi:10.1007/s00540-018-2581-x.
  15. Riley ET, Mangum K, Carvalho B, Butwick AJ. The crystalloid co-load: clinically as effective as colloid preload for preventing hypotension from spinal anaesthesia for caesarean delivery. Turk J Anaesthesiol Reanim. 2019;47(1):35–40. doi:10.5152/TJAR.2018.76402.
  16. Tawfik MM, Tarbay AI, Elaidy AM, Awad KA, Ezz HM, Tolba MA. Combined colloid preload and crystalloid coload versus crystalloid coload during spinal anesthesia for cesarean delivery: a randomized controlled trial. Anesth Analg. 2019;128(2):304–12. doi:10.1213/ANE.0000000000003306.
  17. Ryu C, Choi GJ, Park YH, Kang H. Vasopressors for the management of maternal hypotension during cesarean section under spinal anesthesia: a systematic review and network meta-analysis protocol. Medicine. 2019;98(1):e13947. doi:10.1097/MD.0000000000013947.
  18. Xue X, Lv X, Ma X, Zhou Y, Yu N, Yang Z. Prevention of spinal hypotension during cesarean section: a systematic review and Bayesian network meta-analysis based on ephedrine, phenylephrine, and norepinephrine. J Obstet Gynaecol Res. 2023;49(7):1651–62. doi:10.1111/jog.15671.
  19. Xu C, Liu S, Huang Y, Guo X, Xiao H, Qi D. Phenylephrine vs ephedrine in cesarean delivery under spinal anesthesia: a systematic literature review and meta-analysis. Int J Surg. 2018;60:48-59. doi:10.1016/j.ijsu.2018.10.039.
  20. Xu S, Shen X, Liu S, Yang J, Wang X. Efficacy and safety of norepinephrine versus phenylephrine for the management of maternal hypotension during cesarean delivery with spinal anesthesia: a systematic review and meta-analysis. Medicine (Baltimore). 2019;98(5):e14331. doi:10.1097/MD.0000000000014331.
  21. Pauline A, Arthi K, Parameswari A, Vakamudi M, Manickam A. Prophylactic fixed-rate phenylephrine versus norepinephrine infusion in the prevention of post-spinal anesthesia hypotension during cesarean delivery. Cureus. 2023;15(7):e41251. doi:10.7759/cureus.41251.
  22. Park SK, Park DN, Kim YW, Yoo S, Kim WH, Lim YJ, et al. Colloid coload versus crystalloid coload to prevent maternal hypotension in women receiving prophylactic phenylephrine infusion during caesarean delivery: a randomised controlled trial. Int J Obstet Anesth. 2022;49:103246. doi:10.1016/j.ijoa.2021.103246.
  23. He H, Liu D, Ince C. Colloids and the microcirculation. Anesth Analg. 2018;126(5):1747-54. doi:10.1213/ANE.0000000000002620.
  24. Bassiony MA, Hossny MR, Abdelaziz AA, Mohamed MA, Abdelaziz NM. Colloid co-load versus colloid pre-load in a parturient undergoing caesarean delivery with spinal anaesthesia and its effects on maternal haemodynamics. Egypt J Hosp Med. 2018;71(4):2858–68.
  25. Hassabelnaby YS, Hasanin AM, Shamardal M, Mostafa M, Zaki RM, Elsherbiny M, et al. Epinephrine vs. phenylephrine infusion for prophylaxis against maternal hypotension after spinal anesthesia for cesarean delivery: a randomized controlled trial. J Anesth. 2024;38(4):500–7. doi:10.1007/s00540-024-03344-2.
  26. Hassanin AS, El-Shahawy HF, Hussain SH, Bahaa Eldin AM, Elhawary MM, Elbakery M, et al. Impact of interval between induction of spinal anesthesia to delivery on umbilical arterial cord pH of neonates delivered by elective cesarean section. BMC Pregnancy Childbirth. 2022;22(1):216. doi:10.1186/s12884-022-04536-y.