Anaesthetic complications during elective caesarean delivery and outcomes: A nigerian multi-centre cohort study

Abstract

Background: Elective caesarean deliveries are planned procedures which are not without complications and unfavorable outcomes. We aimed to assess anaesthetic complications, risk factors and outcomes during caesarean delivery in Nigerian hospitals. Materials and Methods: Using a standardized template, we conducted a multi-centre prospective cohort study of parturients presenting for elective caesarean deliveries over a seven-day period in 49 hospitals. Demographic data of enrolled parturients, anaesthetic and surgical characteristics, complications; maternal and neonatal outcomes; ICU admissions and indications were collected. Results: A total of 237 parturients were studied. Previous caesarean section 50 (21%) and preeclampsia 25 (10.5%) were the most common indications for surgery. Regional technique was the most frequently used anaesthetic technique 221 (93.2%). Hypotension was more common with regional technique 29 (13%) than with general anaesthesia 6 (1%). The vast majority (71.8%) of those that developed complications had co-morbidities. Six patients were admitted to the ICU. Obstetric haemorrhage and severe preeclampsia were the most common indications for ICU admissions, 50% and 33% respectively. Two intraoperative cardiac arrests occurred with one survivor. There was one fresh stillbirth, three neonatal admissions and no neonatal death. Conclusion: Hypotension was the most common intraoperative complication during elective caesarean section whilst obstetric haemorrhage remained the major indication for ICU admissions with good outcomes.

Keywords

• elective caesarean delivery
• hypotension
• intraoperative complications
• maternal mortality
• neonatal outcomes