A new trial implemented the first Double Intravenous Vasopressor Automated (DIVA) System during a caesarean section, which gives doctors better control over maternal blood pressure in women compared to manually-administered medication to manage reduced blood pressure (vasopressor).
Doctors at KK Women's and Children's Hospital (KKH) developed the innovative DIVA System, which uses an advanced algorithm to detect and quickly respond to low blood pressure and/or slow heart rate in real time by auto-administering a precise amount of the recommended vasopressor.
Accurate blood pressure monitoring is crucial for optimal timing and dosing of vasopressors. Typical non-invasive blood pressure monitoring is done once every minute, and during that time interval there could potentially be a delay in detecting rapid blood pressure changes. All in all, low blood pressure occurs in almost 60 percent of C-sections under spinal anesthesia, causing nausea and decreased blood flow to the baby.
A randomized controlled double-blind trial was used with a sample of 213 healthy women, ages 21 to 45, with singleton full-term pregnancies. The women underwent elective caesarean delivery under spinal anesthesia, which is common in C-sections.
The group whose blood pressure was managed using the DIVA System experienced better systolic blood pressure control and less nausea than the control group who manually received vasopressors. These results support the same findings from a preliminary study carried out from October 2011 to July 2012 by KKH and Duke-NUS Graduate Medical School (Duke-NUS GMS).
Professor Sia, senior consultant of the Department of Women's Anaesthesia at KKH, explains that the new technique is part of the group's ongoing efforts to make labor safer and easier in a public statement.
"We are always on the lookout for innovative ways to better the quality of care we can provide to patients. The DIVA System helps us to monitor our patients more closely and provide medical intervention almost instantaneously. This provides them a more comfortable experience during caesarean delivery, and most importantly, reinforces maternal and fetal safety."
