Clinical evaluation of anesthesia for cesarean section at tertiary medical center: retrospective study for 5 years (2009-2013).
10.17085/apm.2016.11.1.49
- Author:
Sang Hee PARK
1
;
Dong Jun KIM
;
Woon Young KIM
;
Jae Hwan KIM
;
Yoon Sook LEE
;
Young Cheol PARK
Author Information
1. Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. ckssis@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Cesarean section;
High-risk delivery;
Obstetric anesthesia
- MeSH:
Anesthesia*;
Anesthesia, Obstetrical;
Birth Weight;
Blood Transfusion;
Cesarean Section*;
Emergencies;
Female;
Hemorrhage;
Humans;
Infant, Newborn;
Intensive Care, Neonatal;
Medical Records;
Mothers;
Operative Time;
Pregnancy;
Retrospective Studies*;
Stillbirth
- From:Anesthesia and Pain Medicine
2016;11(1):49-54
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Cesarean section anesthesia requires adequate preparation because of maternal physiologic changes, a higher risk for massive maternal bleeding, neonatal considerations, and a higher frequency of emergency operations. Therefore, we retrospectively compared clinical outcomes of cesarean section patients between a high-risk group and non-high-risk group in order to improve anesthesia care. METHODS: We reviewed medical records from cesarean section cases at our tertiary medical center for 5 years (2009-2013). Parameters included the anesthesia and operative time; estimated blood loss, fluid volume and blood products administered during surgery, additional administration of maternal uterotonic medications; as well as the birth weight, Apgar scores, number of neonatal intensive care unit (NICU) admissions, and stillbirth rates of the neonate. RESULTS: The total number of delivery cases was 1935 during the 5 years, and the cesarean section cases accounted for 58.8% (1,138 cases). There were 735 emergency surgery cases (64.6%), and 813 (71.4%) patients were in the high-risk group. Estimated blood loss, fluid volume used, and the frequency and amount of blood transfusions were statistically higher in the high-risk group. Among 1,243 neonates, 918 (73.9%) were born from high-risk mothers. Neonatal birth weights and Apgar scores (1 and 5 minutes) from patients in the high-risk group were statistically lower than those in the non-high-risk group, and NICU admissions and stillbirths were statistically higher in the high-risk group. CONCLUSIONS: Anesthesiologists should be aware of unfavorable clinical outcomes in high-risk cesarean section groups and carefully prepare for anesthesia care in these cases.
