scholarly journals Anesthesia practice in cesarean delivery in tertiary care hospital: a retrospective observational study

2018 ◽  
Vol 1 (1) ◽  
pp. 13-15
Author(s):  
Rohini Sigdel ◽  
Maya Lama ◽  
Sanish Gurung ◽  
Sushil Timilsina

Background: Regional anesthesia is being utilized as the preferred anesthetic technique for cesarean delivery worldwide. This study was performed to review cesarean delivery anesthetic practice in our institute which represents a tertiary care regional hospital. Methods: Data was collected regarding the number of cesarean delivery performed during the period of six months from January 2017 to June 2017 at Western Regional Hospital. Number of elective versus emergency cesarean delivery, mode of anesthesia and the reason for general anesthesia and complications was recorded. Results: The number of cesarean delivery was found to be 1174(26.41%) of total deliveries during the study period. Out of which, 64.82% were for emergency indication and 35.18% were elective cesarean delivery. Spinal anesthesia was utilized in 99.03% of elective cesarean section and 97.63% of emergency cesarean section. The percentage of cases performed under general anesthesia was 1.87%. Reasons for general anesthesia included inadequate subarachnoid block, fetal malpresentation, eclampsia and maternal comorbidities. Complications related to general anesthesia like failed intubation, airway difficulty related to general anesthesia and anesthesia related mortality was not encountered. Conclusion: Spinal anesthesia is utilized widely and safely in obstetric practice at our hospital. Use of labour epidural analgesia should be introduced and encouraged in our setting to minimize the side effects of single shot spinal anesthesia and to avoid general anesthesia when indicated.

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1755
Author(s):  
Shunji Suzuki

Background: Maternal mental status has been thought to be affected by the delivery modes. We examined the relation between delivery modes and the mental status of women who delivered at our institute in Japan. Methods: Data were collected from the medical charts of 643 primiparous women without a history of mental disorders who delivered singleton babies and underwent a 1-month postpartum check-up at our institute from September 2018 to June 2019. The maternal mental status was examined based on the scores of the Edinburgh Postnatal Depression Scale (EPDS) and the Mother-Infant Bonding Scale (MIBS). Results: The rate of high scores of the EPDS and the MIBS in women choosing elective cesarean section were higher than in women with vaginal delivery and emergency cesarean section. Conclusion: Mental health care may be necessary for women choosing elective cesarean section.


2017 ◽  
Vol 35 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Ziya Kalem ◽  
Tuncay Yuce ◽  
Batuhan Bakırarar ◽  
Feride Söylemez ◽  
Müberra Namlı Kalem

Objective This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery. Study Design This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups. Results The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care. Conclusion Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.


F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1755
Author(s):  
Shunji Suzuki

Background: Maternal mental status has been thought to be affected by the delivery modes. We examined the influence of delivery modes on the mental status of women who delivered at our institute in Japan. Methods: Data were collected from the medical charts of 645 primiparous women without a history of mental disorders who delivered singleton babies and underwent a 1-month postpartum check-up at our institute from September 2018 to June 2019. The maternal mental status was examined based on the scores of the Edinburgh Postnatal Depression Scale (EPDS) and the Mother-Infant Bonding Scale (MIBS). Results: The rate of high scores of the EPDS and the MIBS in women choosing elective cesarean section were higher than in women with vaginal delivery and emergency cesarean section. Conclusion: A fulfilling birth-plan and birth-review may also be necessary for women choosing elective cesarean section.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Khaled El-Radaideh ◽  
Ala’’a Alhowary ◽  
Mohammad Alsawalmeh ◽  
Ahmed Abokmael ◽  
Haitham Odat ◽  
...  

Background. This prospective study compared the blood glucose concentration with spinal anesthesia or general anesthesia in patients undergoing elective cesarean section surgery. Methods. In total, 58 pregnant women who underwent elective cesarean section surgery were included in this prospective comparative study. Group S (n = 35) included patients who chose spinal anesthesia, and group G (n = 23) included patients who chose general anesthesia. The patients were allocated to the groups upon patients’ preference. For the group G, the blood glucose concentration (BGC) was obtained 5 minutes before induction, T1, and 5 minutes after induction T2. For the group S, the BGC was obtained immediately before the injection of the local anesthetic agent T1 and 5 minutes after the complete block T2. For both groups, BGC was measured 5 minutes before the end of surgery T3 and 30 minutes after the end of surgery T4. For BGC measurements, we used a blood glucose monitoring system with a lancet device to prick the finger. Results. There was no statistically significant difference in the mean blood glucose concentration between the groups S and G in T1 (78.3 ± 18.2 vs. 74.3 ± 14.7, p>0.05) and T2 (79.2 ± 18.3 vs. 84.9 ± 23.7, p>0.05). The mean BGC was statistically significantly higher in group G in comparison to group S in the times 5 minutes before (80.2 ± 18.1 vs. 108.4 ± 16.7, p<0.05) and 30 minutes after the end of surgery (80.9 ± 17.7 vs. 121.1 ± 17.4, p<0.05). Conclusion. There is a much lower increase in blood glucose concentration under spinal anesthesia than under general anesthesia. It is reasonable to suggest that the blood sugar concentration must be intraoperatively monitored in patients undergoing general anesthesia.


F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1755
Author(s):  
Shunji Suzuki

Background: Maternal mental status has been thought to be affected by the delivery modes. We examined the influence of delivery modes on the mental status of women who delivered at our institute in Japan. Methods: Data were collected from the medical charts of 645 primiparous women without a history of mental disorders who delivered singleton babies and underwent a 1-month postpartum check-up at our institute from September 2018 to June 2019. The maternal mental status was examined based on the scores of the Edinburgh Postnatal Depression Scale (EPDS) and the Mother-Infant Bonding Scale (MIBS). Results: The rate of high scores of the EPDS and the MIBS in women choosing elective cesarean section were higher than in women with vaginal delivery and emergency cesarean section. Conclusion: Mental health care may be necessary for women choosing elective cesarean section.


2019 ◽  
Vol 26 (03) ◽  
Author(s):  
IFAT BALOCH ◽  
Naseem Bajari ◽  
Sabrina Talpur ◽  
Saima Naz Shaikh

Objectives: To determine the maternal and fetal outcomes in patients presented with major degree of placenta previa at tertiary care Hospital. Study Design: Descriptive cases series study. Setting: Department of Gynaecology and Obstetrics of Liaquat University Hospital Hyderabad. Period: One year from March 2015 to February 2016. Subject and Methods: All patients with major degrees of placenta previa were included in study. Following delivery the examination of neonate was carried out thoroughly including congenital abnormalities, weight of baby and Apgar score. Babies and mothers were examined within postoperative wards till stitches removal and systematically examined for any postoperative complication. All the data was entered in the proforma. Results: Total 50 patients with major degrees of placenta previa were selected. Majority of the women 40% belonged to the age group of 30-35 years. Most of the women 92.0%, were symptomatic and presented with painless vaginal bleeding. Elective cesarean section was performed among 20% patients while 80% patients underwent emergency cesarean section. 70% patients delivered preterm and 30% delivered at term. 3(6%) fetals were still births and 1(2.0%) presented macerated still birth. 16% fetuses developed respiratory distress syndrome, 6% had intrauterine growth restriction and only one had congenital abnormality (spina bifida). Neonatal weight less than 2500-grams was among 90%. Perinatal mortality was 6(12.0%), and according to maternal outcome, mortality rate was low i.e. just 1 subjects passed away. Conclusion: Major degree of placenta previais a significant contributor of obstetric hemorrhage in 02nd and 03rd trimesterof pregnancy as well as it adversely correlates with feto-maternal outcomes. Instant moving the case of obstetric hemorrhage to hospitals, precise diagnosis, sufficient transfusion provision, intervention without delay can reduce the fetomaternal morbidity and mortality.


2021 ◽  
Vol 71 (4) ◽  
pp. 1183-87
Author(s):  
Syed Khurram Naseer ◽  
Aijaz Ali ◽  
Shizan Hamid Feroz ◽  
Dr Danish ◽  
Amir Sohail

Objective: To compare patients undergoing cesarean section under spinal and general anesthesia in terms of neonatal APGAR scores and patient satisfaction. Study Design: Comparative cross-sectional study. Place and Duration of Study: Departments of Anesthesia and Gynecology and Obstetrics, Combined Military Hospital Peshawar, for six months from Mar to Aug 2019. Methodology: In this study, 120 females with a singleton pregnancy of 36-40 weeks, and requiring a non-emergency elective cesarean section were enrolled through consecutive sampling in the study. The patients were randomly allocated into two equal groups of 60 women each through random table numbers. Group A received spinal anesthesia and group B general anesthesia. APGAR score was assessed at 5 minutes after delivery, and score of ≥7 was taken as satisfactory. Patient's satisfaction level regarding anesthesia was recorded on a visual analogue scale of 0 (extremely unsatisfied) to 10 (completely satisfied), and score of ≥7 was taken as satisfactory. Results: Women receiving general anesthesia were more satisfied as compared to receiving spinal anesthesia (95% vs. 78.3%; p-value 0.007). There was no significant difference in terms of APGAR scores in general anesthesia and spinal anesthesia (83.33% versus 90%; p-value 0.283). Conclusion: After an elective caesarean section, more mothers were satisfied after receiving general anesthesia as compared to spinal anesthesia. However, both types of anaesthesia were found to be equally safe for babies born in terms of APGAR scores at 5 minutes.


2013 ◽  
Vol 25 (2) ◽  
pp. 55-63 ◽  
Author(s):  
Fadil Havas ◽  
Mukadder Orhan-sungur ◽  
Yilmaz Yenigun ◽  
Meltem Karadeniz ◽  
Miray Kilic ◽  
...  

2019 ◽  
Vol 5 (1) ◽  
pp. 014-021
Author(s):  
Bedih Balkan ◽  
Mehmet can Ozbas ◽  
Furkan Tontu ◽  
Gunes Ozlem Yıldız ◽  
Gulsum Oya Hergunsel ◽  
...  

Background: Though there are many studies on the effects of anesthesia methods used for cesarean section on the newborn, research on this topic still continues. In our prospective observational study, we investigated the effects of different anesthesia techniques used in routine cesarean deliveries on early neonatal outcomes in our hospital. Methods: This prospective, observational, randomized study included a total of 222 ASA II risk group pregnant women undergoing elective cesarean section at term (38-41 weeks’ gestation) without fetal distress. The women were randomized into three groups. In the general anesthesia with propofol group (Group P, n = 74), anesthesia was induced with 2 mg∙kg-1 propofol and 0.6-0.9 mg∙kg-1 rocuronium. In the general anesthesia with thiopental sodium group (Group T, n = 74), anesthesia was induced with 5 mg∙kg-1 thiopental sodium and 0.6-0.9 mg∙kg-1 rocuronium. Women in the spinal anesthesia group (Group SA, n = 74) were administered 0.5% (10 mg) hypertonic bupivacaine and 10 mcg fentanyl. Results: There were no significant differences between Group SA, Group P, and Group T in terms of delivery time; neonatal 1- and 5-min Apgar scores; neonatal jaundice rates; neonatal systolic, diastolic, or mean blood pressure or peak heart rate; neonatal intensive care requirement; pH, PCO2, PO2 values in cord blood gas; or neonatal glucose and lactate values. The rate of ephedrine use was significantly higher in Group SA than in Group P and Group T. Maternal satisfaction score was higher in Group SA at postoperative 4 hours and in Group P at 24 hours. The number of newborns taken into intensive care unit in Group T was significantly higher in the 1st hour, 4th hour, 5th hour and total. Respectively p value (0.006, 0,048, 0,048, and 0,005). Pain on injection was present in 55% of patients (n = 81), mild in 36% (n = 54), and severe in 18% (n = 27). Myoclonies occurred in 4% of patients (n = 7) and local rash in 6% of patients (n = 10). Differences between formulations did not reach statistical significance. Conclusion: None of the three anesthesia methods showed superiority after elective cesarean delivery. However, spinal anesthesia and general anesthesia with propofol are more appropriate for pregnant women in terms of effects on the neonate.


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