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

J Pregnancy. 2014;2014:325098. doi: 10.1155/2014/325098. Epub 2014 Apr 17.

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 nulliparous. 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.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, General / methods*
  • Anesthesia, Spinal / methods*
  • Anticonvulsants / therapeutic use*
  • Antihypertensive Agents / therapeutic use*
  • Apgar Score
  • Cesarean Section / methods*
  • Female
  • Fetal Mortality
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Labetalol / therapeutic use
  • Magnesium Sulfate / therapeutic use*
  • Maternal Mortality
  • Methyldopa / therapeutic use
  • Pre-Eclampsia / therapy*
  • Pregnancy
  • Premature Birth
  • Prospective Studies
  • Seizures / etiology
  • Seizures / prevention & control*
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult

Substances

  • Anticonvulsants
  • Antihypertensive Agents
  • Methyldopa
  • Magnesium Sulfate
  • Labetalol