Anesthesia Management in Cesarian Section in Pregnant Patients with COVID-19 Diagnoses

Abstract

Aim:The recommendation to avoid general anesthesia in pregnant women with coronavirus disease-2019 (COVID-19) and to use neuraxial blockade techniques, if possible, has not changed over time. On the other hand, general anesthesia also has to be applied to some patients in clinical practice. In this study, we evaluated anesthesia management, maternal outcomes, and clinical course in pregnant women with COVID-19 who delivered by cesarean section.Methods:One hundred and seven pregnant women with COVID-19 who underwent cesarean sections between October 2020 and April 2021 were included in the study. Anesthesia methods, presenting symptoms, comorbidities, laboratory test results, and radiological data at admission, length of hospital stay, intensive care unit admissions, and mortality rates were retrospectively analyzed.Results:Out of 107 pregnant women, 85 underwent cesarean surgery under spinal anesthesia and 22 under general anesthesia. Forty patients (37%) had at least one symptom, whereas sixty-seven (63%) had no symptoms at all. Fifty percent of symptomatic and only 6% of asymptomatic pregnant women were admitted to the intensive care unit, and there was a significant difference between them. Mortality was 30% in symptomatic patients and only 1% in asymptomatic patients, and the difference in mortality was significant (p<0.05).Conclusion:Since the risk of intensive care and mortality is higher, particularly in symptomatic pregnant women with COVID-19, these patients should be evaluated, operated and followed up by experienced teams.

Keywords

• covid-19
• anesthesia
• obstetrical
• spinal
• intensive care units