Anesth Pain Med.  2016 Jan;11(1):49-54. 10.17085/apm.2016.11.1.49.

Clinical evaluation of anesthesia for cesarean section at tertiary medical center: retrospective study for 5 years (2009-2013)

• Park SH
• Kim DJ
• Kim WY
• Kim JH
• Lee YS
• Park YC

• KMID: 2169072
• DOI: http://doi.org/10.17085/apm.2016.11.1.49

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.

Keyword

Cesarean section; High-risk delivery; Obstetric anesthesia

MeSH Terms

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

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