The Effect of Compression Stockings and Leg Elevation on Hemodynamic Stability in Elective Cesarean Sections Under Spinal Anesthesia: A Single-Blind Randomized Controlled Trial

Aim:

This study aimed to evaluate the effects of compression stockings and leg elevation on maternal intraoperative hypotension, vasopressor requirement, and neonatal well-being parameters in women undergoing elective cesarean section spinal anesthesia.

Methods:

This single-blind randomized controlled experimental study was conducted in the obstetrics service and operating room of Afşin State Hospital between November 1, 2023, and February 20, 2025. A total of 90 pregnant women who met the inclusion criteria were randomly assigned into three groups: the compression stockings group (n=30), the leg elevation group (n=30), and the control group (n=30). Spinal anesthesia was administered to all participants according to a standardized protocol. Maternal systolic, diastolic, and mean arterial blood pressure, as well as heart rate, were monitored at regular intervals during the intraoperative period. The occurrence of hypotension, vasopressor use, and side effects such as nausea and vomiting were recorded. Neonatal outcomes included the 5-minute APGAR score and umbilical venous blood gas parameters (pH and base excess). Data were analyzed using appropriate statistical methods.

Results:

Intraoperative systolic, diastolic, and mean arterial blood pressure values were significantly higher in both the compression stockings and leg elevation groups compared to the control group (p<0.05). The rate of vasopressor use was significantly lower in both intervention groups compared to the control group (p<0.05). There were no statistically significant differences among the groups in terms of neonatal APGAR scores, umbilical venous pH, and base excess values (p>0.05).

Conclusion:

The use of compression stockings and leg elevation in women undergoing elective cesarean section تحت spinal anesthesia are effective, safe, and feasible non-pharmacological methods for maintaining maternal hemodynamic stability. These interventions reduce vasopressor requirements and hypotension-related side effects without adversely affecting short-term neonatal outcomes. The findings suggest that these methods can be integrated into clinical nursing practice for the prevention of spinal anesthesia-induced hypotension.

Study Overview

• Status: Completed
• Conditions: Maternal Hypotension Associated With Spinal Anesthesia During Cesarean Section
• Intervention / Treatment: Device: compression stockings; Other: Leg elevation

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kahramanmaraş
    • Kahramanmaraş, Kahramanmaraş, Turkey (Türkiye), 46500
      • Kahramanmaraş Afşin Devlet Hastanesi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

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Inclusion Criteria:

Gestational age between 37-40 weeks, Planned elective cesarean section, Maternal age between 19-40 years, Singleton pregnancy, Planned spinal anesthesia, Estimated fetal weight between 2500-4000 g.

Exclusion Criteria:

Known hypertensive disorders, History of severe lower extremity injury, History of deep vein thrombosis, Use of anticoagulant therapy, Placental invasion or placental localization abnormalities with a high risk of bleeding, Requirement for general anesthesia, Known fetal anomalies, Signs of acute or chronic fetal distress, Development of maternal complications during the operation.

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Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Compression stockings; Moderate-pressure graduated compression stockings were applied	Device: compression stockings; a medical device that applies graduated pressure to the lower extremities to enhance venous return
Experimental: Leg elevation; After spinal anesthesia, a 30° leg elevation was applied to the patient throughout the surgery.	Other: Leg elevation; a positional intervention involving elevation of the lower extremities above the level of the heart to enhance venous return"
No Intervention: Control; Routine surgical preparation is performed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maternal intraoperative hypotension	Maternal hypotension during spinal anesthesia	throughout the cesarean section
Maternal intraoperatif hipotansiyon	Maternal intraoperatif hipotansiyon	throughout the cesarean section

Collaborators and Investigators

• Sponsor: Seçil Yavaş
• Investigators: Principal Investigator: Tülay Bülbül, doçent, Erciyes Üniversitesi

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2023
• Primary Completion (Actual): February 20, 2025
• Study Completion (Actual): February 20, 2025

Study Registration Dates

• First Submitted: December 18, 2025
• First Submitted That Met QC Criteria: April 11, 2026
• First Posted (Actual): April 16, 2026

Study Record Updates

• Last Update Posted (Actual): April 16, 2026
• Last Update Submitted That Met QC Criteria: April 11, 2026
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Spinal anesthesia, elective cesarean section, maternal hypotension, graduated compression stockings, leg elevation, randomized controlled trial
• Additional Relevant MeSH Terms: Equipment and Supplies; Bandages; Compression Bandages; Stockings, Compression
• Other Study ID Numbers: ErciyesU-SBE-SY-02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No