{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:15:44Z","timestamp":1763460944856,"version":"3.45.0"},"reference-count":23,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Locoregional anesthesia (LRA) during cesarean section (CS) is effective but frequently causes hypotension, affecting maternal hemodynamics and fetal outcomes. We investigated whether baseline hemodynamic characteristics predict post-LRA changes, vasopressor needs, and neonatal outcomes. Methods: Women undergoing elective CS with LRA were monitored with USCOM\u00ae (Ultrasonic Cardiac Output Monitor), recording cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke volume index (SVI), and systemic vascular resistance (SVR) every five minutes. Maternal demographics, vasopressor use, and neonatal outcomes were analyzed using multilevel linear regression. Results: LRA caused significant reductions in blood pressure and heart rate (p &lt; 0.001). SV initially declined but recovered, while SVR showed minimal variation. Vasopressors were required in 63%, with choice guided by heart rate. Lower baseline SVI predicted greater vasopressor need (37.9 \u00b1 6.7 vs. 34.5 \u00b1 6.6, p = 0.050). Lower CO and CI before fetal extraction correlated with reduced neonatal pH, with CI significantly associated with pH &lt; 7.20 (p = 0.043). Conclusions: USCOM\u00ae enables real-time, non-invasive monitoring, supporting individualized management during CS.<\/jats:p>","DOI":"10.3390\/diagnostics15222846","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T11:47:27Z","timestamp":1762775247000},"page":"2846","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing Hemodynamic Changes During Locoregional Anesthesia in Cesarean Section: The Role of USCOM\u00ae"],"prefix":"10.3390","volume":"15","author":[{"given":"Agnese","family":"Lambertini","sequence":"first","affiliation":[{"name":"General and Pediatric Anesthesia and Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7345-1418","authenticated-orcid":false,"given":"Sara","family":"Doroldi","sequence":"additional","affiliation":[{"name":"Obstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania Maria","family":"Mucci","sequence":"additional","affiliation":[{"name":"General and Pediatric Anesthesia and Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Porzio","sequence":"additional","affiliation":[{"name":"General and Pediatric Anesthesia and Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1759-5664","authenticated-orcid":false,"given":"Fabio","family":"Caramelli","sequence":"additional","affiliation":[{"name":"General and Pediatric Anesthesia and Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluigi","family":"Pilu","sequence":"additional","affiliation":[{"name":"Obstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3176-9184","authenticated-orcid":false,"given":"Elisa","family":"Montaguti","sequence":"additional","affiliation":[{"name":"Obstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1002\/uog.17504","article-title":"Maternal hemodynamics in normal pregnancy: Reference ranges and role of maternal characteristics","volume":"51","author":"Vinayagam","year":"2018","journal-title":"Ultrasound Obstet. 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