Comparing the Effect of Spinal and General Anaesthesia for Pre-Eclamptic Mothers Who Underwent Caesarean Delivery in A Tertiary, Addis Ababa, Ethiopia

Background Opinions are controversial regarding the use of general and spinal anesthesia in pre-eclamptic mothers undergoing Caesarean section. Some studies recommended avoiding spinal anesthesia in pre-eclamptic patients because of concern for sudden severe hypotension, while other studies support the use of spinal anesthesia as first choice reasoning less post-operative morbidity and mortality. This study aims to compare maternal outcome among pre-eclamptic women undergone caesarian delivery under general and spinal anesthesia. Methods and Patients A retrospective comparative cross-sectional study was conducted to compare maternal outcome. All pre-eclamptic mothers who underwent Caesarian section in Black Lion Specialized Hospital from October 2014 to October 2016 were included in the study. Data entry and analysis were conducted using SPSS version 20. Student's T-test was used to compare the outcome in both groups and p value < 0.05 was set as cut off point for statistical significance. Results A total of 170 client documents were reviewed. The mean age of the study subjects was 28.18 ± 4.66 years, with median age 28 years (IQR: 25–30). Our study shows that both general and spinal anesthesia have no difference in terms of maternal survival status, days of hospital stay, post-operative admission to ICU, and post-operative complications. However, this study found a statistically significant higher post-operative blood pressure and pulse rate among general anesthesia groups compared with spinal anesthesia group. Conclusion Spinal anesthesia is safer than general anesthesia in terms of stable vital signs among pre-eclamptic women undergoing Cesarean section.

[1]  T. Ravi,et al.  Analysis of maternal outcome of general versus spinal anaesthesia for caesarean delivery in severe pre-eclampsia , 2016 .

[2]  Jun Zhang,et al.  The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014 , 2016, PloS one.

[3]  Ö. Özdamar,et al.  Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial. , 2015, Sao Paulo medical journal = Revista paulista de medicina.

[4]  K. Shrestha Spinal Anesthesia for Cesarean section in Preeclampsia , 2015 .

[5]  Zewditu Abdissa Denu,et al.  Trends in Obstetrics Anesthesia, at Gondar University Hospital , 2015 .

[6]  S. Pahari,et al.  Fetomaternal Outcome in Severe Preeclamptic Women Undergoing Emergency Cesarean Section under Either General Or Spinal Anesthesia , 2014, Journal of pregnancy.

[7]  R. Safaeian,et al.  Comparison Between Spinal and General Anesthesia in Percutaneous Nephrolithotomy , 2013, Anesthesiology and pain medicine.

[8]  G. J. Crystal,et al.  The Bainbridge and the “Reverse” Bainbridge Reflexes: History, Physiology, and Clinical Relevance , 2012, Anesthesia and analgesia.

[9]  Y. Gebrehiwot,et al.  Disease burden due to pre‐eclampsia/eclampsia and the Ethiopian health system's response , 2011, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[10]  Z. Khan Preeclampsia/eclampsia: an insight into the dilemma of treatment by the anesthesiologist. , 2011, Acta medica Iranica.

[11]  A. Abdella Maternal Mortality Trend in Ethiopia , 2010 .

[12]  Shiliang Liu,et al.  Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. , 2007, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[13]  V. Peduto,et al.  Maternal and neonatal outcome after cesarean section: The impact of anesthesia , 2007, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[14]  I. Hindawi,et al.  Spinal versus general anesthesia for elective cesarean delivery: a prospective comparative study. , 2001, Clinical and experimental obstetrics & gynecology.

[15]  J. Neal Hypotension and Bradycardia During Spinal Anesthesia: Significance, Prevention, and Treatment , 2000 .

[16]  J. Martin,et al.  Cardiopulmonary Morbidity as a Complication of Severe Preeclampsia HELLP Syndrome , 2000, Journal of Perinatology.