Our anesthesia experiences in <scp>COVID</scp>‐19 positive patients delivering by cesarean section: A retrospective single‐center cohort study

Karasu, Derya; Kilicarslan, Nermin; Özgünay, Şeyda Efsun; Gürbüz, Hande

doi:10.1111/jog.14852

Cited by 16 publications

(13 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study findings seem to support this assumption when viewed in combination with pre‐pandemic UK data [22]. The regional anaesthesia rate for caesarean birth in our study was higher than reported in studies from the USA (91.3%) [13], Europe (75%) and France (72%) [20, 21], and comparable with a small single‐centre study from Turkey (95%) [32]. Accordingly, the GA rate for caesarean section was lower in our sample than in other studies [13, 20, 21].…”

Section: Discussionsupporting

confidence: 90%

Obstetric analgesia and anaesthesia in SARS‐CoV‐2‐positive parturients across 10 maternity units in the north‐west of England: a retrospective cohort study

Bhatia

Columb²,

Eslam³

et al. 2022

Anaesthesia

View full text Add to dashboard Cite

Since the start of the COVID-19 pandemic, few studies have reported anaesthetic outcomes in parturients with SARS-CoV-2 infection. We reviewed the labour analgesic and anaesthetic interventions utilised in symptomatic and asymptomatic parturients who had a confirmed positive test for SARS-CoV-2 across 10 hospitals in the north-west of England between 1 April 2020 and 31 May 2021. Primary outcomes analysed included the analgesic/anaesthetic technique utilised for labour and caesarean birth. Secondary outcomes included a comparison of maternal characteristics, caesarean birth rate, maternal critical care admission rate along with adverse composite neonatal outcomes. A positive SARS-CoV-2 test was recorded in 836 parturients with 263 (31.4%) reported to have symptoms of COVID-19. Neuraxial labour analgesia was utilised in 104 (20.4%) of the 509 parturients who went on to have a vaginal birth. No differences in epidural analgesia rates were observed between symptomatic and asymptomatic parturients (OR 1.03, 95%CI 0.64-1.67; p = 0.90). The neuraxial anaesthesia rate in 310 parturients who underwent caesarean delivery was 94.2% (95%CI 90.6-96.0%). The rates of general anaesthesia were similar in symptomatic and asymptomatic parturients (6% vs. 5.7%; p = 0.52). Symptomatic parturients were more likely to be multiparous (OR 1.64,; p = 0.002); of Asian ethnicity (OR 1.54, 1.04-2.28; p = 0.03); to deliver prematurely (OR 2.16,; p = 0.001); have a higher caesarean birth rate (44.5% vs. 33.7%; OR 1.57, 95%CI 1.16-2.12; p = 0.008); and a higher critical care utilisation rate both pre-(8% vs. 0%, p = 0.001) and post-delivery (11% vs. 3.5%; OR 3.43, 95%CI 1.83-6.52; p = 0.001). Eight neonates tested positive for SARS-CoV-2 while no differences in adverse composite neonatal outcomes were observed between those born to symptomatic and asymptomatic mothers (25.8% vs. 23.8%; OR 1.11, 95%CI 0.78-1.57; p = 0.55). In women with COVID-19, non-neuraxial analgesic regimens were commonly utilised for labour while neuraxial anaesthesia was employed for the majority of caesarean births. Symptomatic women with COVID-19 are at increased risk of significant maternal morbidity including preterm birth, caesarean birth and peripartum critical care admission.

show abstract

Section: Discussionsupporting

confidence: 90%

Obstetric analgesia and anaesthesia in SARS‐CoV‐2‐positive parturients across 10 maternity units in the north‐west of England: a retrospective cohort study

Bhatia

Columb²,

Eslam³

et al. 2022

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…An increased risk of preterm delivery and fetal compromise has been described in pregnancies complicated with COVID-19. 1,[19][20][21] The majority of pregnant women in the study were in their third trimester, and approximately one-third of them delivered preterm. Importantly, our study supports that preterm delivery and low birth weight are associated with maternal COVID-19 severity.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and hematological parameters associated with disease severity in COVID‐19 positive pregnant women undergoing cesarean section: A single‐center experience

Bora

Bicer

Şahin

et al. 2021

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Aim: The study aimed to describe clinical characteristics and outcomes of pregnant women with COVID-19 undergoing cesarean section, and evaluated the association of blood values at admission with severe COVID-19 disease in this group of patients. Method: We retrospectively analyzed the clinical data of 110 patients infected with COVID-19 who underwent cesarean section at Adana City Education and Research Hospital in Turkey. The COVID-19 severity of the patients was classified as either severe or nonsevere disease according to World Health Organization of COVID-19 clinical management guidance. We compared blood values, clinical characteristics, and outcomes between severe and nonsevere patients. Receiver operating characteristics (ROC) curves analyses and area under the ROC curve (AUC) value was calculated to evaluate the predictive value of blood parameters on the COVID-19 severity. Results: Of the 110 women, 12 were severe cases. Severe patients had higher ferritin, neutrophil-tolymphocyte ratio (NLR), lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate transaminase (AST), and procalcitonin levels on admission (p < 0.05). The ROC analysis demonstrated AUC of NLR, LDH, AST, ALT, ferritin, and procalcitonin was 0.757, 0.856, 0.840, 0.771, 0.821, and 0.698, respectively. The LDH had a maximum specificity (90.8%), with the cutoff value of 365. The O-blood group was more likely to have severe illness than the non-O-blood group (relative risk: 3.6; 95% confidence interval; 1.2-10.4). Conclusion:This study shows that LDH values at admission are an early and powerful predictor of severe infection for pregnant women with COVID-19 who will undergo a cesarean section.

show abstract

“…In comparison, in a study conducted in India on 115 patients, 5 cases were admitted to the ICU, out of which 1 patient (0.87%) died on the seventh postoperative day [ 31 ]. On the other hand, in a study including 61 COVID-19 positive cesarean deliveries in Turkey [ 32 ], in which 58 (95.1%) underwent spinal anesthesia, 1 case was admitted to the ICU after delivery under spinal anesthesia, she was intubated later on, and received mechanical ventilation for 68 days, after which she was discharged from the ICU 108 days after her admission. Among the three remaining patients who received general anesthesia, one patient was already intubated at the ICU due to respiratory worsening preoperatively, and she died on the tenth day of ICU follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Among the three remaining patients who received general anesthesia, one patient was already intubated at the ICU due to respiratory worsening preoperatively, and she died on the tenth day of ICU follow-up. Based on these findings, Karasu et al, concluded that the mortality rate was 1.6% in all patients, 5.0% in symptomatic patients, and 11.1% in patients with pneumonia [ 32 ]. In the current study, the only mortality case was mainly related to the patient’s pre-operative respiratory condition.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Outcomes in COVID-19 Obstetric Patients Undergoing Spinal Anesthesia for Cesarean Section: A Prospective Observational Study

et al. 2021

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19) adds more challenges to the perioperative management of parturients. The aim of this study is to examine perioperative adverse events and hemodynamic stability among COVID-19 positive parturients undergoing spinal anesthesia. This prospective observational investigation was conducted at a tertiary teaching hospital in Jordan between January and June 2021, during which 31 COVID-19 positive parturients were identified. Each COVID-19 positive parturient was matched with a COVID-19 negative parturient who received anesthesia under similar operating conditions as a control group. Of the 31 COVID-19 patients, 22 (71%) were otherwise medically free, 8 (25.8%) were emergency cesarean sections. The sensory level of spinal block after 10 min was T8 (T6–T10) among COVID-19 positive group, compared to T4 (T4–T6) among control group (p = 0.001). There were no significant differences in heart rate, SBP, DBP, and MAP intraoperatively (p > 0.05). Twelve (36.4%) neonates born to COVID-19 positive patients were admitted to NICU, compared to four (11.8%) among control group (p = 0.018). There was no statistically significant difference in postoperative complications. In conclusion, spinal anesthesia is considered a safe anesthetic technique in COVID-19 parturients, and therefore it is the anesthetic method of choice for cesarean deliveries among COVID-19 patients.

show abstract

Our anesthesia experiences in COVID‐19 positive patients delivering by cesarean section: A retrospective single‐center cohort study

Cited by 16 publications

References 18 publications

Obstetric analgesia and anaesthesia in SARS‐CoV‐2‐positive parturients across 10 maternity units in the north‐west of England: a retrospective cohort study

Obstetric analgesia and anaesthesia in SARS‐CoV‐2‐positive parturients across 10 maternity units in the north‐west of England: a retrospective cohort study

Clinical characteristics and hematological parameters associated with disease severity in COVID‐19 positive pregnant women undergoing cesarean section: A single‐center experience

Perioperative Outcomes in COVID-19 Obstetric Patients Undergoing Spinal Anesthesia for Cesarean Section: A Prospective Observational Study

Contact Info

Product

Resources

About