Evaluation of 254 cesarean sections with COVID-19 in terms of anesthesia and clinical course: 1-year experience

Abstract

PurposeThe study aims to compare anesthesia methods, clinical course, and maternal and fetal outcomes of symptomatic and asymptomatic pregnant women undergoing cesarean operation with confirmed COVID-19. Methods 254 pregnant women with COVID-19 who had a cesarean section in our hospital between March 2020 and March 2021 were included in the study. Demographic information, laboratory test results, radiological data, treatments, anesthesia methods, and prognoses of the patients were evaluated retrospectively. Results On admission, 160 (63%) patients were asymptomatic (Group A), and 94 (37%) patients were symptomatic (Group S). The ratio of patients who needed oxygen therapy in the obstetric ward (p < 0.001) and intraoperative period (p < 0.001) and ICU admission (p = 0.005) was higher in Group S. Neutrophil-to-lymphocyte ratio (NLR), ferritin, procalcitonin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were higher in Group S. In both groups, spinal anesthesia was performed predominantly. The rate of general anesthesia was significantly higher in Group S (16.0% vs. 4.4%, p = 0.003). No difference was found in the amount of sedatives during the spinal anesthesia. Conclusion Close follow-up of the laboratory values and comorbidities (especially asthma) of pregnant will provide information about the clinical course as in other patient groups. Spinal anesthesia is a safe and sufficient anesthesia method in both symptomatic and asymptomatic COVID-19 pregnant women when performed by experienced hands.

Impact of perioperative COVID-19 infection on postoperative complication in cesarean section using Korean National Health insurance data

“…The results did not reveal significant differences in outcomes based on the chosen anesthesia method. Various confounding factors, such as fetal distress, deterioration of the mother’s health, catheter failure, and inappropriate timing of LMWH for regional anesthesia, contribute to the preference for general anesthesia over neuraxial anesthesia, making outcome comparisons challenging 37 .…”

A meta-analysis on first-trimester blood count parameters—is the neutrophil-to-lymphocyte ratio a potentially novel method for first-trimester preeclampsia screening?

“…NLR was studied in pregnant COVID-19 patients as well ( 74 , 75 ): Aydin Güzey et al ( 76 ) evaluated 254 cesarean sections with COVID-19 and found elevated levels of NLR among the symptomatic patients. Our research group also presented a case report where we found elevated NLR in a preeclamptic COVID-19 patient ( 77 ).…”