Maternal and neonatal outcome after cesarean section: the impact of anesthesia.
BACKGROUND
Among the anesthetic technologies used, regional anesthesia is becoming the most common in cesarean section (CS) deliveries. Aim. This retrospective survey examined the variables taken into account when selecting the anesthetic technique to be used, and how this choice affects the outcome for the mother and the newborn.


METHODS
One thousand eight hundred and seventy elective and emergency CS were evaluated for anesthetic technique used, indications, and maternal and neonatal outcome.


RESULTS
Of the 611 elective CS (32.6%), 206 (33.8%) were performed under general anesthesia and 405 (66.2%) under regional anesthesia. Of the 1259 emergency CS performed (67.4%), 525 (41.9%) were under general anesthesia and 734 (58.1%) under regional anesthesia. Conditions associated with a newborn 1-minute Apgar score of <7 were general anesthesia and multiple pregnancy (p<0.01); a 5-minute Apgar score of <7 was only associated with multiple pregnancy. The most important factor for very low Apgar scores was the presence of fetal malformations. Whatever the chosen technique, neither maternal deaths directly or indirectly due to the anesthesia nor major maternal and perinatal complications were found.


CONCLUSIONS
This survey confirms the preference for regional anesthesia during elective cesarean sections and for general anesthesia in emergency situations. Moreover, newborn outcome was found not to be influenced either by the technique used or by the character of the procedure.
Gori
F
F
Department of Clinical and Experimental Medicine, Section of Anaesthesiology, Analgesia and Intensive Care, University of Perugia School of Medicine, Perugia, Italy. bobo.gori@libero.it
Pasqualucci
A
A
Corradetti
F
F
Milli
M
M
Peduto
V A
VA
D000765:Anesthesia, Conduction / Q000706:statistics & numerical data*; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D000773:Anesthesia, Obstetrical / Q000379:methods / Q000706:statistics & numerical data*; D000777:Anesthetics / Q000009:adverse effects; D001034:Apgar Score; D002585:Cesarean Section; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D000777:Anesthetics