Anesthesia Type Outcome in Severe Pre-eclampsia with Caesarean Section

Authors

  • Haitham Jaber Al Dallal Al-Imam Al-Sajjad Hospital, Al-Najaf Health Directorate, Al-Najaf, Iraq
  • Bayan Thuban Al-Jobury Al-Imam Al-Sajjad Hospital, Al-Najaf Health Directorate, Al-Najaf, Iraq

DOI:

https://doi.org/10.54133/ajms.v7i1.1067

Keywords:

Cesarean section, General anesthesia, Maternal mortality, Perinatal mortality, Severe pre-eclampsia, Spinal anesthesia

Abstract

Background: Preeclampsia is a hypertensive disorder during pregnancy with fetomaternal mortality. The choice of anesthesia method for cesarean sections among preeclamptic women is still debated. Objective: To compare the outcomes of spinal and general anesthesia in a cesarean section among preeclamptic women. Methods: A prospective study was conducted at Al-Imam Al-Sajjad Hospital/Al-Najaf Health Directorate from February 2021 to September 2023. Women undergoing cesarean sections due to severe preeclampsia were enrolled in the spinal or general anesthesia group. Data on maternal age, gestational age at delivery, parity, Apgar scores, maternal mortality and perinatal mortality were recorded. The background characteristics and outcomes were compared between both groups. We excluded women with mild preeclampsia, multiple pregnancies, other pregnancy medical disorders, gestational age < 32 weeks, cases of eclampsia, and general anesthesia following spinal anesthesia failure. Results: The general anesthesia group had a significantly lower Apgar score at 1 minute than the spinal anesthesia group (27.3% and 57.4%, p=0.006), and at 5 minutes (15.2% and 37.03%, p=0.005). The study groups showed no significant difference regarding maternal and perinatal mortality. Conclusions: Maternal and perinatal mortality were not affected by anesthesia type in severe preeclampsia, but general anesthesia caused a higher proportion of birth asphyxia.

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References

Campbell NE, Deer EM, Herrock OT, LaMarca BB. The Role of Different Lymphoid Cell Populations in Preeclampsia Pathophysiology. Kidney360. 2022;3(10):1785-1794. doi: 10.34067/KID.0001282022.

Padhan SC, Pradhan P, Panda B, Pradhan SK, Mishra SK. Risk Factors of Pre-eclampsia: A Hospital-Based Case-Control Study. Cureus. 2023;15(7):e42543. doi: 10.7759/cureus.42543.

Pridjian G, Puschett JB. Preeclampsia. Part 1: clinical and pathophysiologic considerations. Obstet Gynecol Surv. 2002;57(9):598-618. doi: 10.1097/00006254-200209000-00023.

Portelli M, Baron B. Clinical Presentation of Preeclampsia and the Diagnostic Value of Proteins and Their Methylation Products as Biomarkers in Pregnant Women with Preeclampsia and Their Newborns. J Pregnancy. 2018;2018:2632637. doi: 10.1155/2018/2632637.

Lambert G, Brichant JF, Hartstein G, Bonhomme V, Dewandre PY. Preeclampsia: an update. Acta Anaesthesiol Belg. 2014;65(4):137-149. PMID: 25622379.

Rana S, Lemoine E, Granger JP, Karumanchi SA. Preeclampsia: Pathophysiology, Challenges, and Perspectives. Circ Res. 2020;126(1):e8. doi: 10.1161/CIRCRESAHA.118.313276.

Gofton E, Capewell V, Natale R, Gratton R. Obstetric intervention rates and maternal and neonatal outcomes of women with gestational hypertension. Am J Obstet Gynecol. 2001;185:798-803. doi: 10.1067/mob.2001.117314.

Unal BS, Dennis AT. Perioperative Complications in Patients with Preeclampsia Undergoing Caesarean Section Surgery. J Clin Med. 2023;12(22):7050. doi: 10.3390/jcm12227050.

Tihtonen K, Kööbi T, Yli-Hankala A, Huhtala H, Uotila J. Maternal haemodynamics in pre-eclampsia compared with normal pregnancy during caesarean delivery. BJOG. 2006;113(6):657-663. doi: 10.1111/j.1471-0528.2006.00931.x.

Cheng C, Liao AHW, Chen CY, Lin YC, Kang YN. A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section. Sci Rep. 2021;11:5630. doi: 10.1038/s41598-021-85179-5.

Ramkumar J, Sharma N. Anesthesia in severe preeclampsia. Open Access J Trans Med Res. 2018;2(5):134‒136. doi: 10.15406/oajtmr.2018.02.0005.

Goddard J, Wee MYK, Vinayakarao L. Update on hypertensive disorders in pregnancy. BJA Educ. 2020;20(12):411-416. doi: 10.1016/j.bjae.2020.07.007.

Khan B, Allah Yar R, Khakwani AK, Karim S, Arslan Ali H. Preeclampsia Incidence and Its Maternal and Neonatal Outcomes With Associated Risk Factors. Cureus. 2022;14(11):e31143. doi: 10.7759/cureus.31143.

Thangaswamy CR, Kundra P, Velayudhan S, Aswini LN, Veena P. Influence of anaesthetic technique on maternal and foetal outcome in category 1 caesarean sections - A prospective single-centre observational study. Indian J Anaesth. 2018;62(11):844-850. doi: 10.4103/ija.IJA_406_18.

Jordaan M, Reed AR, Cloete E, Dyer RA. A retrospective audit of anaesthesia for caesarean section in parturients with eclampsia at a tertiary referral hospital in Cape Town. South Afr J Anaesth Analg. 2020;26(4):192-197.

Keerath K, Cronje L. Observational study of choice of anaesthesia and outcome in patients with severe preeclampsia who present for emergency Caesarean section. South Afr J Anaesth Analg. 2012;18(4):206-212.

Dyer RA, Els I, Farbas J, Torr GJ, Schoeman LK, James MF. Prospective, randomized trial comparing general with spinal anesthesia for cesarean delivery in preeclamptic patients with a nonreassuring fetal heart trace. Anesthesiology. 2003;99(3):561-566A. doi: 10.1097/00000542-200309000-00010.

Chumpathong S, Sirithanetbhol S, Salakij B, Visalyaputra S, Parakkamodom S, Wataganara T. Maternal and neonatal outcomes in women with severe pre-eclampsia undergoing cesarean section: a 10-year retrospective study from a single tertiary care center: anesthetic point of view. J Matern Fetal Neonatal Med. 2016;29(24):4096-4100. doi: 10.3109/14767058.2016.1159674.

Neme D, Aweke Z, Jemal B, Mulgeta H, Regasa T, Garolla G, et al. Effect of anesthesia choice on hemodynamic stability and fetomaternal outcome of the preeclamptic patient undergoing cesarean section. Ann Med Surg (Lond). 2022;77:103654. doi: 10.1016/j.amsu.2022.103654.

Aregawi A, Terefe T, Admasu W, Akalu L. Comparing the Effect of Spinal and General Anaesthesia for Pre-Eclamptic Mothers Who Underwent Caesarean Delivery in A Tertiary, Addis Ababa, Ethiopia. Ethiop J Health Sci. 2018;28(4):443-450. doi: 10.4314/ejhs.v28i4.10.

Okafor UV, Okezie O. Maternal and fetal outcome of anaesthesia for caesarean delivery in preeclampsia/eclampsia in Enugu, Nigeria: a retrospective observational study. Int J Obstet Anesth. 2005;14(2):108-113. doi: 10.1016/j.ijoa.2004.10.011.

Aya AGM, Mangin R, Vialles N, Ferrer JM, Robert C, Ripart J, et al. Patients with severe preeclampsia experience less hypotension during spinal anesthesia for elective cesarean delivery than healthy parturients: a prospective cohort comparison. Anesth Analg. 2003;97(3):867-872. doi: 10.1213/01.ANE.0000073610.23885.F2.

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Published

2024-07-23

How to Cite

Al Dallal, H. J., & Al-Jobury, B. T. (2024). Anesthesia Type Outcome in Severe Pre-eclampsia with Caesarean Section. Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ), 7(1), 93–97. https://doi.org/10.54133/ajms.v7i1.1067

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