Clinical evaluation of anesthesia for cesarean section of the patients with hypertensive disorders in pregnancy: retrospective study for 10 years.
- Author:
Eun Chi BANG
1
;
Hyun Sook LEE
;
Yong In KANG
;
Kyung Sook CHO
;
Su Yeon KIM
;
Jun Young KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, CHA University, Seoul, Korea. ecbang63@hanmail.net
- Publication Type:Original Article
- Keywords:
Cesarean section;
Epidural anesthesia;
General anesthesia;
Hypertensive disorders in pregnancy;
Spinal anesthesia
- MeSH:
Anesthesia;
Anesthesia, Conduction;
Anesthesia, Epidural;
Anesthesia, General;
Anesthesia, Spinal;
Apgar Score;
Birth Weight;
Cesarean Section;
Emergencies;
Female;
Humans;
Magnesium Sulfate;
Medical Records;
Pregnancy;
Pregnancy, Multiple;
Retrospective Studies
- From:Anesthesia and Pain Medicine
2009;4(4):341-347
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: There are many difficulties in anesthetic management for cesarean section of the patients with hypertension.The anesthetic management of hypertensive disorders in pregnancy has been controversial. METHODS: We reviewed the medical records of the patients with hypertensive disorders in pregnancy from Jan., 1998 to Dec., 2007, and made clinical analysis of the anesthesia for cesarean section. RESULTS: Of the total 775 parturients with hypertensive disorders, 638 (82.3%) was delivered by cesarean section.Indications for cesarean section were, in order of frequency, hypertensive disorders in pregnancy (36.9%), multiple pregnancy (13.8%), previous cesarean section (11.6%), etc.Of the total cesarean section, 468 (73.4%) were emergency cases.The majority of preoperative systolic blood pressures were 141-160 mmHg (36.2%) and 161-180 mmHg (35.2%). The majority of preoperative diastolic blood pressures were 91-100 mmHg (28.6%) and 101-110 mmHg (25.0%). 350 (54.9%) had epidural anesthesia, 195 (30.5%) had general anesthesia, and 93 (14.6%) had spinal anesthesia.Estimated blood loss was significantly lower after regional anesthesia than after general anesthesia.In patients received magnesium sulfate (MgSO4), (40.0% of total) 83.5% had regional anesthesia and 16.5% had general anesthesia.In the cases with MgSO4 1 min Apgar score was lower and neonatal birth weight was smaller than in cases without MgSO4. CONCLUSIONS: Anesthesiologist must have much attention on the prevention, treatment and anesthetic management for cesarean section of patients with hypertensive disorders in pregnancy.
