Perinatology.  2023 Sep;34(3):128-134. 10.14734/PN.2023.34.3.128.

Comparison of Neonatal Outcomes among Patients Undergoing Cesarean Delivery under General or Spinal Anesthesia

• Joo YJ
• Jeon GW
• Lee J
• Jun YH

• KMID: 2546717
• DOI: http://doi.org/10.14734/PN.2023.34.3.128

Abstract

Objective
Spinal anesthesia (SA) is the preferred option for cesarean delivery because of its lower risk to both the mother and fetus. However, general anesthesia (GA) is used in emergencies to minimize the time between the decision to proceed with surgery and delivery. We compared neonatal out comes associated with different anesthesia types in cesarean delivery, specifically SA and GA. Further more, we examined the factors influencing the use of GA in cesarean deliveries.
Methods
A total of 154 and 208 patients with a gestational age of ≥37 weeks who received GA (GA group) and SA (SA group), admitted between January 2011 and December 2020, were analyzed.
Results
Of all the patients, 41.3% underwent GA. The reasons for GA were as follows: unknown causes (including failed SA, 28.2%), placenta previa (25.0%), maternal request (21.3%), maternal health condition (13.8%), and fetal health condition (11.7%). Apgar scores at 1 and 5 minutes in the GA group were significantly lower than in the SA group. The incidences of resuscitation at birth, admission to the neonatal intensive care unit, and respiratory support were higher in the GA group than in the SA group.
Conclusion
SA during cesarean delivery was associated with better neonatal outcomes. It is crucial to minimize the use of GA during cesarean delivery when it is not medically necessary to improve maternal and neonatal outcomes.

Keyword

General anesthesia; Spinal anesthesia; Cesarean section; Placenta previa