Keywords : Acute renal Failure - Blood Pressure - Cesarean Section
Foeto-Maternal Outcome In Severe Pre–Eclampsia Patients Undergoing Emergency Lower Segment Caesarean Section Under Spinal And General Anaesthesia
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 2841-2851
Pregnancy-induced hypertension constitutes a significant cause of morbidity and mortality in developing nations and complicates about 6-8% of pregnancies. Severe preeclampsia poses a serious dilemma for the anaesthesiologist, especially in emergencies, with respect to difficulty in endotracheal intubation and exaggerated haemodynamic responses due to anaesthetic procedures.
Objective: This study aimed to observe intra-operative haemodynamic, anaesthesia parameters, maternal and foetal complications and indications of the need for postoperative critical care. Methods: This study included 145 patients with severe pre-eclampsia who underwent emergency caesarean section. Out of 145 patients, 103 patients were administered spinal anaesthesia (SA), and 42 patients received general anaesthesia (GA) based on the consent of the patient, fasting status of the patient, maternal and foetal distress and active respiratory tract infection (RTI). Patients were categorised into two groups: those who received SA as Group S and those who received GA as Group G.
Results: The Mean intra-operative SBP in group S and group G was 129.8±14.23 mmHg and 136.5±17.25 mmHg respectively, with statistically significant differences (p-value of 0.017). Mean intra-operative DBP group S and group G were 79.1±12.64mmHg and 85.4±15.38mmHg, respectively, with statistically significant differences (p-value of 0.012). The most common maternal complication among group S was headache (6.8%), and among the group G was pulmonary oedema (8.3%) (p<0.001). 74.8% of patients in group S and 31% in group G were complications-free (p<0.001). Out of 103 patients in group S, nine (8.7%) were admitted to ICU and 19 (45.2%) out of 42 patients in group G. The difference was statistically significant (p-value< 0.001).
Conclusion: Spinal anaesthesia is a safer alternative to general anaesthesia in severe preeclampsia, with less postoperative morbidity and mortality for mothers and babies. These findings agreed with many previous studies worldwide.