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Fetomaternal outcome in severe preeclamptic women undergoing emergency cesarean section under either general or spinal anesthesia.

Chattopadhyay S, Das A, Pahari S - J Pregnancy (2014)

Bottom Line: Significantly more neonates of patients receiving GA were found to be preterm (77.8% versus 44.5%; P < 0.01) and required advanced resuscitation.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Medical College & Hospital, 88 College Street, Kolkata 700073, India ; BC 103, Salt Lake, Kolkata 700064, India.

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 iparous. 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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Mentions: The exclusion criteria in this study were as follows: eclamptic patients; patients having previous history of medical disorders like chronic hypertension, diabetes, connective tissue disorder, thyroid dysfunction, epilepsy, renal disease, heart disease, and obesity; patients having any severe allergic reaction; patients having abruptio placenta or placenta previa; patient having coagulopathy, thrombocytopenia with platelet count less than 80,000/cm3, sepsis, neurological problems, hypovolemia, or pulmonary edema; multiple gestations or any congenital anomalies of new born baby. See Figure 1.


Fetomaternal outcome in severe preeclamptic women undergoing emergency cesarean section under either general or spinal anesthesia.

Chattopadhyay S, Das A, Pahari S - J Pregnancy (2014)

© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4016895&req=5

Mentions: The exclusion criteria in this study were as follows: eclamptic patients; patients having previous history of medical disorders like chronic hypertension, diabetes, connective tissue disorder, thyroid dysfunction, epilepsy, renal disease, heart disease, and obesity; patients having any severe allergic reaction; patients having abruptio placenta or placenta previa; patient having coagulopathy, thrombocytopenia with platelet count less than 80,000/cm3, sepsis, neurological problems, hypovolemia, or pulmonary edema; multiple gestations or any congenital anomalies of new born baby. See Figure 1.

Bottom Line: Significantly more neonates of patients receiving GA were found to be preterm (77.8% versus 44.5%; P < 0.01) and required advanced resuscitation.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Medical College & Hospital, 88 College Street, Kolkata 700073, India ; BC 103, Salt Lake, Kolkata 700064, India.

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 iparous. 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.

Show MeSH