Impact of anesthetic methods on neonatal outcome in women receiving temporary balloon occlusion of the common iliac artery during cesarean section for placenta accreta.
OBJECTIVE
Placenta accreta is associated with significant maternal morbidity and is the leading indication for peripartum hysterectomy. In our institution, occlusion balloon catheters are commonly placed in bilateral common iliac arteries in order to reduce blood loss and facilitate surgery in patients with this obstetric complication. Few studies, however, have evaluated the effect of different anesthetic methods for cesarean hysterectomy on neonatal outcome. In this study, we compared Apgar scores among neonates born to mothers under general anesthesia with those who received regional anesthesia.


METHODS
A retrospective analysis of 19 women with placenta accreta/percreta who underwent cesarean hysterectomy in our hospital, revealed that the 1-minute Apgar score was <7 in 4/12 neonates born to women who underwent general anesthesia and in 1/7 neonates born to mothers who received regional anesthesia. The 5-minute Apgar score was >7 after immediate resuscitation in all neonates. There were no significant differences in demographic data, induction-to-delivery period, or Apgar scores between the general and the regional anesthesia groups.


CONCLUSIONS
We acknowledge that the retrospective nature of this study makes it difficult to conclude whether the different anesthesia management strategies had an impact on Apgar score; however, according to our clinical observation, regional anesthesia may be a better alternative in the induction-to-delivery period, especially for women with accreta/percreta and in situations in which poor neonatal outcome is expected.
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Jheng-Yan
JY
Lan
Mao-Hsien
MH
Wang
Shou-Zen
SZ
Fan
Li-Kuei
LK
Chen
D000328:Adult; D000770:Anesthesia, Endotracheal / Q000009:adverse effects; D000768:Anesthesia, General / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D000775:Anesthesia, Spinal / Q000009:adverse effects; D001034:Apgar Score; D021721:Balloon Occlusion; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007083:Iliac Artery; D007231:Infant, Newborn; D010921:Placenta Accreta / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies