【Objective】 To evaluate the influence of hypertonic sodium chloride hydroxyethyl starch 40 (HSH40) on hypotension induced by spinal anesthesia for cesarean delivery and on neonate. 【Methods】 Sixty termed parturients (ASA I-II) scheduled for cesarean section were randomly divided into Group HSH40 (n = 30) and Group RL (n = 30). HSH40 250 mL and Ringer lactate solution 500 mL were infused in 15 to 20 min before intrathecal administration of local anesthetics in Group HSH40 and Group RL

respectively. Spinal anesthesia was performed at lumber 3/4 interspaces with 0.5 % bupivocaine 2 mL. Incidence of severe hypotension (Systolic blood pressure <100 mmHg

1 mmHg = 0.133 kP ) was recorded in 15 min after induction of spinal anesthesia. The Apgar scores at 1 and 5 minutes were evaluated and the umbilical blood samples were collected for blood gas analysis. 【Results】 Patient characteristics were comparable between the two groups(P > 0.05). In 15 min after intrathecal administration of local anesthetics

the incidence of hypotension (Systolic blood pressure )< 100 mmHg

< 90 mmHg and < 80 mmHg in Group RL and Group HSH40 were 80.0 % vs 40.0 %

63.3 % vs 10.0 %

and 40.0 % vs 6.7 %

respectively (P < 0.01). No difference in blood gas analysis of umbilical blood samples was found(P > 0.05). The sodium concentration of umbilical blood samples was higher in Group HSH40 than in Group RL(P < 0.01). 【Conclusion】 HSH40 preloading can not eliminate severe hypotension induced by spinal anesthesia for cesarean section

can not improve the early outcome of the neonates

but increased sodium concentration in umbilical cord

it should be prudent to use cesarean delivery.