Hiiraan Online

Mogadishu (HOL) — More than three-quarters of Somali women who gave birth by cesarean section under spinal anesthesia at Mogadishu’s main referral hospital suffered dangerous drops in blood pressure, according to a new medical study.

The research, published in BMC Pregnancy and Childbirth, examined 320 mothers who underwent cesarean deliveries at Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital between May and July 2024. It reported a 78 percent incidence of spinal anesthesia–induced hypotension, a complication that can cause dizziness, fainting, or, in severe cases, life-threatening harm to both mother and newborn.

The study was conducted by Somali researchers Asha Abdullahi Barud, Ikran Abdulkadir Ali, Nasra Mohamud Hilowle, Hiba Bashir Hassan and Iftin Mohamed Osman.

The study found five significant risk factors. Women with a body mass index above 25 were more than twice as likely to experience complications, while those with anemia before surgery faced increased risks. Mothers who did not receive intravenous fluid preloading or the vasopressor drug ephedrine were especially vulnerable. Surprisingly, women without high blood pressure during pregnancy were six times more likely to suffer hypotension than those with hypertensive disorders.

Spinal anesthesia is widely used in Somalia because it is considered safer and less costly than general anesthesia. But hypotension, which is the most common complication, can trigger nausea, fainting, dizziness, fetal acidosis, and in severe cases, cardiac arrest or maternal and neonatal death. In South Africa, spinal hypotension has been linked to more than half of anesthesia-related maternal deaths.

The complication rate documented in Mogadishu exceeded those reported in Ethiopia, Pakistan, and Colombia, highlighting the strain on Somalia’s maternal health system.

The authors concluded that “targeted interventions — such as preoperative risk screening, hemoglobin optimization, and prophylactic ephedrine use — are recommended to reduce the occurrence of spinal anesthesia-induced hypotension”.

Somalia already faces one of the highest maternal mortality rates in the world. Health experts say the findings illustrate the urgent need for preventive measures and investment in obstetric care. With one of the fastest-growing populations in the Horn of Africa, even routine complications in childbirth carry outsized risks for Somali mothers and newborns.