title: Fetomaternal outcome in severe preeclamptic women undergoing emergency cesarean section under either general or spinal anesthesia.
abstract: This prospective observational study compared the effects of general and spinal anesthesia in 173 severe preeclamptic women undergoing emergency cesarean section. 146 (84.5%) patients underwent spinal anesthesia (SA) and 27 (15.5%) patients had general anesthesia (GA). Most of the patients were primigravid and nulliparous. Intraoperatively SA group required more intravenous fluid and vasopressor support, while GA group required more preoperative labetalol injection for blood pressure control. Overall 13.3% of patients required critical care, particularly GA group (44.4% versus 7.5%; P < 0.001). Patients receiving GA had a higher mortality (25.9% versus 1.4%; P < 0.001). The length of hospital stay was comparable. Significantly more neonates of patients receiving GA were found to be preterm (77.8% versus 44.5%; P < 0.01) and required advanced resuscitation. GA group also had higher neonatal mortality (29.6% versus 11%; P < 0.05). To conclude, severe preeclamptic mothers receiving general anesthesia and their babies required more critical care support. Maternal as well as neonatal mortality was significantly higher with general anesthesia.
authors.affiliation: Department of Anaesthesiology, Medical College & Hospital, 88 College Street, Kolkata 700073, India ; BC 103, Salt Lake, Kolkata 700064, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Chattopadhyay
authors.affiliation: Department of Anaesthesiology, Medical College & Hospital, 88 College Street, Kolkata 700073, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Das
authors.affiliation: Department of Anaesthesiology, Medical College & Hospital, 88 College Street, Kolkata 700073, India.
authors.forename: Subrata
authors.initials: S
authors.lastname: Pahari
mesh_terms: D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D000927:Anticonvulsants / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001034:Apgar Score; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D046689:Fetal Mortality; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007741:Labetalol / Q000627:therapeutic use; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008428:Maternal Mortality; D008750:Methyldopa / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000628:therapy*; D011247:Pregnancy; D047928:Premature Birth; D011446:Prospective Studies; D012640:Seizures / Q000209:etiology / Q000517:prevention & control*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000959:Antihypertensive Agents; D008750:Methyldopa; D008278:Magnesium Sulfate; D007741:Labetalol