Epidural compared with general anaesthesia for caesarean delivery in conscious women with eclampsia

Moodley, J.; Jjuuko, G; Rout, C C

doi:10.1111/j.1471-0528.2001.00097.x

Cited by 26 publications

(7 citation statements)

References 28 publications

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“…However, not all studies held a similar view. Ajuzieogu et al [15], Moodley et al [21], and Santos and Birnbach [22] found similar neonatal outcomes irrespective of anesthesia administered. Laudenbach et al [23] on the other hand noted a higher risk of mortality in neonates in the spinal group compared to general and epidural anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Fetomaternal Outcome in Severe Preeclamptic Women Undergoing Emergency Cesarean Section under Either General Or Spinal Anesthesia

Chattopadhyay

Das

Pahari

2014

Journal of Pregnancy

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This prospective observational study compared the effects of general and spinal anesthesia in 173 severe preeclamptic women undergoing emergency cesarean section. 146 (84.5%) patients underwent spinal anesthesia (SA) and 27 (15.5%) patients had general anesthesia (GA). Most of the patients were primigravid and nulliparous. Intraoperatively SA group required more intravenous fluid and vasopressor support, while GA group required more preoperative labetalol injection for blood pressure control. Overall 13.3% of patients required critical care, particularly GA group (44.4% versus 7.5%; P < 0.001). Patients receiving GA had a higher mortality (25.9% versus 1.4%; P < 0.001). The length of hospital stay was comparable. Significantly more neonates of patients receiving GA were found to be preterm (77.8% versus 44.5%; P < 0.01) and required advanced resuscitation. GA group also had higher neonatal mortality (29.6% versus 11%; P < 0.05). To conclude, severe preeclamptic mothers receiving general anesthesia and their babies required more critical care support. Maternal as well as neonatal mortality was significantly higher with general anesthesia.

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Section: Discussionmentioning

confidence: 99%

Fetomaternal Outcome in Severe Preeclamptic Women Undergoing Emergency Cesarean Section under Either General Or Spinal Anesthesia

Chattopadhyay

Das

Pahari

2014

Journal of Pregnancy

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“…A prospective randomized, multicenter study conducted by Visalyaputra S et al [8] concluded that SAB was safe for CS in patients with severe preeclampsia. The incidence and magnitude of hypotension following SAB for CS are lesser in patients with severe preeclampsia when compared with healthy parturients [9] as hypertension is not sympathetically mediated [10] in preeclampsia.…”

Section: Hypertensive Disorders Of Pregnancy Can Be Defined As Followsmentioning

confidence: 88%

Combined-Spinal-Epidural Anesthesia in a Parturient with Gestational Hypertension with Acute and Extremely Elevated Blood Pressure Undergoing Emergency Caesarean Section

2014

JACCOA

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hypertension undergoing caesarean section who presented with acute and extreme rise of blood pressure (BP). She was successfully managed by combined-spinal-epidural (CSE) technique. Case Presentation A 40-year female, weighing 60 kg, gravida 5, abortion 4 and no living child, with 37 weeks gestational age was admitted because of her bad obstetric history to the Department of Obstetrics and Gynaecology of our hospital. She was diagnosed to have gestational hypertension during her fourth pregnancy and gestational diabetes mellitus during the current. She was receiving oral Nifedipine retard 10 mg since 28 weeks of gestation. Her blood sugars were well controlled on diet. On admission, her heart rate (HR) was 80/min and BP 140/90 mmHg. The dose of oral Nifedipine retard 10 mg was increased to twice daily and later, to thrice daily. Investigations were as follows: hemoglobin 12.2 g/dl, blood group 'O' positive, blood urea 13 mg/dl, serum creatinine 0.6 mg/dl, uric acid 3 mg/dl, platelet count 163000/mm 3 , aspartate aminotransferase 14 U/L, alanine aminotransferase 15 U/L, lactate dehydrogenase-347 U/L, prothrombine time 12.7 seconds (test) and 12.2 seconds (control), activated partial thromboplastin time 29 seconds (test) and 28 seconds (control), and INR 1.04. Urine routine was within normal limits and there was no proteinuria. She was scheduled for an elective CS a week later. Two days after the admission, her BP remained elevated (170/100 mmHg) in spite of medications. However, there was no history of headache, blurring of vision, epigastric pain, decreased urine output or any other symptoms and signs of preeclampsia.

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“…Women who have had an eclamptic seizure but are fully conscious and co-operative, have a platelet count 4 100 6 10 9 l 71 and have received magnesium sulphate can undergo regional anaesthesia safely (Moodley et al, 2001). An incremental epidural technique was used in this case to allow haemodynamic stability during gradual establishment of the block.…”

Section: Discussionmentioning

confidence: 99%

All that glisters … a generalised seizure at 31 weeks

Adams

Levy²,

Reid³

et al. 2004

Journal of Obstetrics and Gynaecology

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Epidural compared with general anaesthesia for caesarean delivery in conscious women with eclampsia

Cited by 26 publications

References 28 publications

Fetomaternal Outcome in Severe Preeclamptic Women Undergoing Emergency Cesarean Section under Either General Or Spinal Anesthesia

Fetomaternal Outcome in Severe Preeclamptic Women Undergoing Emergency Cesarean Section under Either General Or Spinal Anesthesia

Combined-Spinal-Epidural Anesthesia in a Parturient with Gestational Hypertension with Acute and Extremely Elevated Blood Pressure Undergoing Emergency Caesarean Section

All that glisters … a generalised seizure at 31 weeks

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