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

J Obstet Gynaecol Res. 2021 Aug;47(8):2659-2665. doi: 10.1111/jog.14852. Epub 2021 May 13.

Abstract

Aim: Pregnancy increases susceptibility to respiratory complications of viral diseases. This study aims to evaluate our anesthesia practices in pregnant women with COVID-19 undergoing cesarean section.

Methods: A total of 61 patients who underwent cesarean section and had positive Polymerase chain reaction (PCR) testing for COVID-19 with nasopharyngeal swabs were included in the study. Patient demographics and information about anesthesia were analyzed retrospectively from the patient medical files.

Results: A total of 61 parturients undergoing cesarean section that had positive SARS-CoV-2 PCR tests were assessed. General anesthesia was applied to only three patients (4.9%), while spinal anesthesia was administered to the remaining 58 patients (95.1%). The incidence of hypotension was 25.9% in the spinal anesthesia group. Forty-one (67.2%) parturients were asymptomatic. While the rate of pneumonia in symptomatic patients was 45% (9/20), the pneumonia incidence among all SARS-CoV-2 PCR (+) parturients was 14% (9/61). Three (4.9%) COVID-19 patients required intensive care in the perioperative period. The overall mortality rate was 1.6% (1/61) among parturients with COVID-19 undergoing cesarean section, while it was 11.1% (1/9) in patients with pneumonia.

Conclusion: It was observed that COVID-19 is associated with mortality in pregnant women undergoing cesarean section. Spinal anesthesia was safely and effectively administered in COVID-19 parturients, especially in patients with pneumonia.

Keywords: COVID-19; anesthesia; cesarean section; pneumonia.

MeSH terms

  • Anesthesia, Obstetrical*
  • Anesthesia, Spinal* / adverse effects
  • COVID-19 Testing
  • COVID-19*
  • Cesarean Section
  • Cohort Studies
  • Female
  • Humans
  • Pregnancy
  • Retrospective Studies
  • SARS-CoV-2