Management of Anesthesia in Pre-Eclamptic Patients with Covid 19 Infection

Abstract

Background: Pregnant women with immunological and cardiopulmonary system abnormalities may experience more severe symptoms from respiratory virus infections. Objectives: The aim of this study was to assess the management of anesthesia in pre eclamptic patients with covid 19 infection. Methods: This cross-sectional descriptive study was carried out in the Department of Anaesthesia, Uttara Adhunik Medical College Hospital, during October 2020 to September 2021. A total of 50 pregnant women with pre-eclampsia and had positive polymerase chain reaction (PCR) test for COVID-19 with nasopharyngeal swabs were included in the study irrespective of age and patients who were not willing to participate were and who were clinically suspected (such as a clinical situation or travel history) but tested negative for COVID-19 excluded from this study. Statistical analyses of the results were be obtained by using window based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-22), where required. Results: The mean age of the patients was 26± 2.0 years. 36% patients were within 26-31 weeks of gestational age, 40% patients were within 32-36 weeks of gestational age, 20% patients were within 37-42 weeks of gestational age, and only 4% had more than 42 weeks of gestational age. About 60% patients had mild pre-eclampsia and 40% had severe pre-eclampsia. 98% patients had given spinal anesthesia and 2% had given epidural type of anesthesia. The indication for caesarian section was 50% for severe pre-eclampsia, 25% for uterine rupture in pre-eclampsia and 25% for previous caesarean section. The mean Hemoglobin was 12.17 ± 1.70, mean Aspartate aminotransferase was 28.05 ± 21.11, mean Alanine aminotransferase, was 17.06 ± 12.98, mean Creatine was 0.68 ± 0.71, mean C-reactive protein was 2.10 ± 2.33 and mean D-Dimer was 3.00 ± 2.26. About 60% of the patients were fit to discharge within 4 days and 40% within 5 days. Conclusion: Preeclampsia as one of pregnancy related complications is a notable burden of adverse health. Regional anaesthesia is not considered to be prohibited by the diagnosis of COVID-19 alone. In conclusion, COVID-19-infected pregnant women should be managed by specialised teams in a multidisciplinary facility, and all medical personnel involved in the caesarean section should be careful to use Level-3 PPE equipment. Due to the increased risk of infection and morbidity in general anaesthesia in pregnant women with COVID-19, regional anaesthesia becomes more prevalent. We also noted that there is no umbilical chord transmission from mother to child.