Maternal and fetal outcomes in women undergoing caesarean section under general and spinal anesthesia

Abstract

Background: Both spinal and general anaesthesia used for caesarean section have certain advantages and disadvantages and there is no method which is completely ideal. The most important factors for choice of anaesthesia are; pregnant systemic problems and wishes, the urgency of the operation, and the surgeon and the anesthetists experience. Aim of the Work: These studies aimed at comparing maternal and fetal outcomes in women undergoing elective caesarean section and have spinal anaesthesia with those having general anaesthesia. Subjects and Methods: This study was carried out at Ain Shams University Maternity Hospital during the period from December 2017 to August 2018 after approval of the hospital health ethical committee. It included 186 patients who had C.S and were subdivided into 2 groups according to a randomization scale. On the day of the operation, each randomly received a closed opaque envelope for the selection of the procedure (spinal versus general). Results: We noted that the mean haemoglobin and haematocrit values at the 24th hour were higher in the spinal anaesthesia group. The estimated blood loss volume was significantly higher in the general anaesthesia group. The median apgar score at the first and the fifth minutes were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer in the spinal anaesthesia group. Conclusion and Recommendations: General anaesthesia could be thought the quickest anaesthesia method in an emergency since it avoids the possibility of a failed regional block. Meanwhile, it is associated with higher possibility of blood loss and low Apgar score. Thus, using spinal anaesthesia for elective caesarean section is recommended provided that adequate maternal hydration is established and sparing general anaesthesia for emergency caesarean sections or whenever spinal anaesthesia is contraindicated (e.g. coagulopathy, sever thrombocytopenia, anticoagulation or sever degree of malformation of spine).