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General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study
BACKGROUND: Acute foetal distress (AFD) is a life-threatening foetal condition complicating 2% of all pregnancies and accounting for 8.9% of caesarean sections (CS) especially in developing nations. Despite the severity of the problem, no evidence exists as to the safest anaesthetic technique for th...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931547/ https://www.ncbi.nlm.nih.gov/pubmed/33663391 http://dx.doi.org/10.1186/s12871-021-01289-7 |
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author | Metogo, Junette Arlette Mbengono Nana, Theophile Njamen Ngongheh, Brian Ajong Nyuydzefon, Emelinda Berinyuy Adjahoung, Christoph Akazong Tochie, Joel Noutakdie Minkande, Jacqueline Ze |
author_facet | Metogo, Junette Arlette Mbengono Nana, Theophile Njamen Ngongheh, Brian Ajong Nyuydzefon, Emelinda Berinyuy Adjahoung, Christoph Akazong Tochie, Joel Noutakdie Minkande, Jacqueline Ze |
author_sort | Metogo, Junette Arlette Mbengono |
collection | PubMed |
description | BACKGROUND: Acute foetal distress (AFD) is a life-threatening foetal condition complicating 2% of all pregnancies and accounting for 8.9% of caesarean sections (CS) especially in developing nations. Despite the severity of the problem, no evidence exists as to the safest anaesthetic technique for the mother and foetus couple undergoing CS for AFD. We aimed to compare general anaesthesia (GA) versus regional (spinal and epidural) anaesthesia in terms of their perioperative maternal and foetal outcomes. METHODS: We carried out a retrospective cohort study by reviewing the medical records of all women who underwent CS indicated for AFD between 2015 to 2018 at the Douala General Hospital, Cameroon. Medical records of neonates were also reviewed. We sought to investigate the association between GA, and regional anaesthesia administered during CS for AFD and foetal and maternal outcomes. The threshold of statistical significance was set at 0.05. RESULTS: We enrolled the medical records of 117 pregnant women who underwent CS indicated for AFD. Their mean age and mean gestational age were 30.5 ± 4.8 years and 40 weeks respectively. Eighty-three (70.9%), 29 (24.8%) and 05 (4.3%) pregnant women underwent CS under SA, GA and EA respectively. Neonates delivered by CS under GA were more likely to have a significantly low APGAR score at both the 1st (RR = 1.93, p = 0.014) and third-minute (RR = 2.52, p = 0.012) and to be resuscitated at birth (RR = 2.15, p = 0.015). Past CS, FHR pattern on CTG didn’t affect these results in multivariate analysis. Adverse maternal outcomes are shown to be higher following SA when compared to GA. CONCLUSION: The study infers an association between CS performed for AFD under GA and foetal morbidity. This, however, failed to translate into a difference in perinatal mortality when comparing GA vs RA. This finding does not discount the role of GA, but we emphasize the need for specific precautions like adequate anticipation for neonatal resuscitation to reduce neonatal complications associated with CS performed for AFD under GA. |
format | Online Article Text |
id | pubmed-7931547 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79315472021-03-05 General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study Metogo, Junette Arlette Mbengono Nana, Theophile Njamen Ngongheh, Brian Ajong Nyuydzefon, Emelinda Berinyuy Adjahoung, Christoph Akazong Tochie, Joel Noutakdie Minkande, Jacqueline Ze BMC Anesthesiol Research Article BACKGROUND: Acute foetal distress (AFD) is a life-threatening foetal condition complicating 2% of all pregnancies and accounting for 8.9% of caesarean sections (CS) especially in developing nations. Despite the severity of the problem, no evidence exists as to the safest anaesthetic technique for the mother and foetus couple undergoing CS for AFD. We aimed to compare general anaesthesia (GA) versus regional (spinal and epidural) anaesthesia in terms of their perioperative maternal and foetal outcomes. METHODS: We carried out a retrospective cohort study by reviewing the medical records of all women who underwent CS indicated for AFD between 2015 to 2018 at the Douala General Hospital, Cameroon. Medical records of neonates were also reviewed. We sought to investigate the association between GA, and regional anaesthesia administered during CS for AFD and foetal and maternal outcomes. The threshold of statistical significance was set at 0.05. RESULTS: We enrolled the medical records of 117 pregnant women who underwent CS indicated for AFD. Their mean age and mean gestational age were 30.5 ± 4.8 years and 40 weeks respectively. Eighty-three (70.9%), 29 (24.8%) and 05 (4.3%) pregnant women underwent CS under SA, GA and EA respectively. Neonates delivered by CS under GA were more likely to have a significantly low APGAR score at both the 1st (RR = 1.93, p = 0.014) and third-minute (RR = 2.52, p = 0.012) and to be resuscitated at birth (RR = 2.15, p = 0.015). Past CS, FHR pattern on CTG didn’t affect these results in multivariate analysis. Adverse maternal outcomes are shown to be higher following SA when compared to GA. CONCLUSION: The study infers an association between CS performed for AFD under GA and foetal morbidity. This, however, failed to translate into a difference in perinatal mortality when comparing GA vs RA. This finding does not discount the role of GA, but we emphasize the need for specific precautions like adequate anticipation for neonatal resuscitation to reduce neonatal complications associated with CS performed for AFD under GA. BioMed Central 2021-03-04 /pmc/articles/PMC7931547/ /pubmed/33663391 http://dx.doi.org/10.1186/s12871-021-01289-7 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Metogo, Junette Arlette Mbengono Nana, Theophile Njamen Ngongheh, Brian Ajong Nyuydzefon, Emelinda Berinyuy Adjahoung, Christoph Akazong Tochie, Joel Noutakdie Minkande, Jacqueline Ze General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study |
title | General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study |
title_full | General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study |
title_fullStr | General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study |
title_full_unstemmed | General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study |
title_short | General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study |
title_sort | general versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931547/ https://www.ncbi.nlm.nih.gov/pubmed/33663391 http://dx.doi.org/10.1186/s12871-021-01289-7 |
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