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

Abstract

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.

Risk factors for advanced resuscitation in term and near-term infants: a case–control study

“…This is consistent with the identification of a significant level of risk for neonatal encephalopathy recently published by Walsh et al 17 in the analysis of a cohort of 76 810 term singleton neonates. Our findings regarding the increase in the risk associated with GETA as well as with ECS are also consistent with other studies addressing these conditions 4 18 19…”

Comparative study of general with Spinal Anesthesia on maternal outcomes for caesarean delivery among preeclamptic women at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

“…This result shows GA groups had relatively elevated pulse rate and blood pressure when compared with SA group. This finding is in line with prospective study conducted in India, retrospective study conducted in Pakistan and randomized controlled study conducted in India which found prevalence of uncontrolled hypertension and tachycardia to be higher among GA group when compared with SA group (AhsanUl-Haq, 2004;Chattopadhyay et al, 2014;Denu et al, 2015). This result could be explained by the exaggerated response of patients' to laryngoscopy after intubation of endotracheal tube.…”

Prospective, non-randomized, parallel group, comparative observational study to compare maternal and neonatal outcome after regional and general anesthesia for Lower Segment Caesarean Section

“…There was no significant difference in the birth weight between the two anesthetic procedures for LSCS which was consistent with other studies. 15,29 There was a significant difference in the number of NICU admissions between the groups. Similar observations were made in several other previous studies.…”

“…Other studies have also reported a higher incidence of respiratory distress in the neonates following CS under GA increasing the need for resuscitation and endotracheal intubation compared to the procedure under RA. 11,13,28,29 Majority of the subjects from both the groups had normal APGAR scores (>7). However, there was a significant difference in the mean score between the groups.…”

“…However, there was a significant difference in the mean score between the groups. Other studies have also reported higher mean APGAR scores in neonates under RA compared to GA. 11,[14][15][16]29 This may be because of the neonatal depression produced by several CNS depressant drugs used in GA which cross the placenta due to high lipid solubility as compared to RA. There was improvement in the APGAR score from 1 min to 5 min, in both the groups.…”