Background Cesarean section is a widely performed surgery. Objective To compare anesthetic types regarding feto-maternal outcomes. Materials and Methods Retrospective comparative study of 3599 cesarean sections (emergency and elective categories). Results Mean APGAR score was statistically higher in the spinal than general anesthesia among the emergency category, P = 0.000 and 0.026, respectively, with no significant difference in the elective category. Estimated blood loss among the elective category was statistically significantly higher in the spinal than general anesthesia, P = 0.001. However, among the emergency category, it was significantly higher in the general than in spinal or epidural anesthesia, P = 0.000. Diclofenac sodium was used more after spinal than general anesthesia (P = 0.000), with no significant difference between epidural and general or between epidural and spinal anesthesia. Pethidine hydrochloride (HCL) was used more after general than after spinal anesthesia (P = 0.000). However, pethidine HCL use was not statistically significantly different between spinal and epidural anesthesia. In the elective category, paracetamol was requested more after spinal than epidural or general anesthesia, P = 0.000. No significant difference was seen between epidural and general anesthesia, P = 1.000. No statistically significant difference was found among the anesthetic types in both categories regarding tramadol HCL. Length of hospital stay, operative time and neonatal intensive care unit admission were not statistically different between anesthetic modes. In the emergency category, significantly higher percentage of patients were satisfied with and would recommend epidural anesthesia. Conclusion There was no statistically significant difference among the three types of anesthesia regarding neonatal intensive care admission and length of hospital stay for emergency and elective categories. APGAR score was higher with spinal than with general anesthesia in the emergency category with no significant difference in the elective category. More diclofenac sodium and paracetamol and less opioids were used after regional than after general anesthesia. Satisfaction was higher with epidural anesthesia. Limitations Retrospective and single centered.

Background: Endometrial ablation is a safe and effective minimally invasive surgical procedure. Despite the high success rate of endometrial ablation for heavy uterine bleeding management, some patients experience persistent symptoms after the procedure, necessitating a hysterectomy. The aim of this study is to determine the pre-operative clinical predictive factors of failure of endometrial ablation in the management of uterine bleeding. Methods: Retrospective cohort study of endometrial ablation procedures performed for treating heavy uterine bleeding. Results: Ninety five patients were included in the study. The failure rate was 24.2%. There was a statistically significant association between ablation failure and fluid deficit (p = 0.002) and intra-operative blood loss (p = 0.047). There was a statistically significant moderate association between adenomyosis (p = 0.003, φ = 0.37) and failed endometrial ablation. However, the age, body mass index (BMI), parity, number of miscarriages, number of cesarean sections, uterine length, endometrial thickness and procedure duration had no significant association with endometrial ablation. There was no significant relationship between the uterine abnormalities in general and the outcome of the endometrial ablation (p = 0.637). However, patients with combined adenomyosis and dysmenorrhea had a statistically significant association with outcome of the endometrial ablation (p = 0.016, φ = 0.28) and were more likely to have a failed endometrial ablation (crude odds ratio (COR) = 4.67, 95% confidence interval (CI), 1.35-16.09). Logistic regression to adjust for related factors revealed that the adenomyosis (adjusted odds ratio (AOR) = 50.83, 95% CI, 3.64-706.75, p = 0.003) and fluid deficit (AOR = 1.003, 95% CI, 1.000-1.006, p = 0.044) had a higher likelihood of an unsuccessful outcome. Hysterectomy was performed in 47.8% of patients who had failure of the ablation. Conclusions: Among pre-operative factors, adenomyosis, fluid deficit and combined adenomyosis and dysmenorrhea were found to predict failure of hysteroscopic endometrial ablation. Clinical Trial Registration: It was registered in https://www.clinicaltrials.gov database with Identifier: NCT05483348.