The type of anesthesia and outcome in preeclamptic patients undergoing cesarean section: An observational study

Abstract

Background and Aims: To study the effect of the type of anesthesia (general anesthesia [GA] or spinal anesthesia [SA]) on maternal hemodynamics and maternal and fetal outcomes in preeclamptic female patients posted for cesarean section delivery, as well as to note down the complications. Materials and Methods: After institutional review board and ethics committee approval, 80 consenting preeclamptic female patients who underwent lower segment cesarean section in our tertiary care center from February 2014 to September 2015 were included in this prospective, observational clinical study. Those with antepartum hemorrhage such as placenta previa, abruptio placenta, cardiac disease, and chronic renal disease were excluded. Those included were divided into two groups, those receiving GA or SA. Baseline and intraoperative heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure, and oxygen saturation were recorded along with demographic data. Use of colloids, blood and blood products, and details of vasopressor drugs administered were noted. Birth weight of the baby and Apgar score at 1 min and 5 min were also noted. Results: Baseline SBP was comparable in the two groups, but baseline DBP was significantly more in the GA group. The intraoperative rise in SBP and DBP was significantly more in the GA than in the SA group. The vasopressor requirement was statistically more in the SA group. The maternal outcome, neonatal outcome, and Apgar score were significantly better in the SA group. Conclusion: In our study, hypotension that occurred during SA could be successfully managed with titrated doses of intravenous vasopressor drugs such as ephedrine or phenylephrine. The neonatal outcome and Apgar score were poorer in the GA group.

Keywords

• general anesthesia
• hemodynamics
• preeclampsia
• spinal anesthesia