Hemodynamic Effects of Spinal Anesthesia in HIV-Positive Pregnant Women

At the 19th World Congress of the Societies of Anaesthesiologists (WCSA 2026) in Marrakesh, TopMedTalk welcomes Desiree Chappell back alongside Kate Leslie to interview Professor Palesa Motshabi-Chakane, Associate Professor and Head of Anaesthesiology at the University of the Witwatersrand and her colleague, Dr Mullai Slave a PhD candidate at University of the Witwatersrand. They discuss a study of 629 women undergoing cesarean section with spinal anesthesia at Chris Hani Baragwanath Hospital, where 23–33% are HIV positive. Using standard monitoring plus BD APM noninvasive continuous hemodynamic monitoring, they compared HIV-positive and HIV-negative patients and found higher hypotension incidence in HIV-positive women (68% vs 64%), with lower heart rate and lower cardiac index over 60 minutes. Additional testing included echocardiography with speckle tracking, pro-BNP, and autonomic assessments, with HIV-positive patients showing stiffer ventricles; Apgar scores did not differ. They discuss replication, multicenter research, and potential machine-learning tools to predict hypotension risk, and describe BD Advanced Patient Monitoring grant support enabling equipment, sensors, staffing, and training (~200 staff) to complete data collection in about six months. Edwards Lifesciences is now known as Becton Dickinson Advanced Patient Monitoring (BD APM). Desiree Chappell, former Co Editor in Chief of TopMedTalk, is now Director, Medical Science Liaison, Medical Affairs, BD Advanced Patient Monitoring. The views expressed on this program are her own and not those of her employers. We mention Adrian Gelb, if you'd like to hear his recent conversation with us go here: https://topmedtalk.libsyn.com/professor-adrian-gelb-on-patient-safety-and-essential-medicines-in-anaesthesia -- Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood. Register here - https://ebpom.org/product/ebpom-world-congress-2026/