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- W1963921922 abstract "The cesarean delivery rate is more than 34% in the U.S., and is expected to continue to rise. Women undergo cesarean delivery under general anesthesia (GA) for several reasons, some of which may increase maternal and neonatal morbidities. We compared maternal and neonatal outcomes for women undergoing cesarean delivery under GA vs. other types of anesthesia (spinal, epidural, narcotics, and local) to assess the effect of anesthetic on outcome. A subset of women who underwent primary or repeat cesarean delivery were identified from the NICHHD MFMU Network registry, which collected data on pregnancy outcomes from patients at 19 centers from 1999-2002. We compared outcomes including time to delivery, birthweight, Apgars, need for prolonged ventilation, and maternal/neonatal death among patients receiving GA vs. other anesthesia. 54,632 patients underwent cesarean, of whom 4,172 underwent GA and 50,460 underwent another type of anesthesia. Women who received GA were more likely to have an abruption, chorioamnionitis, pulmonary edema, emergency cesarean, abnormal placentation, maternal ICU admission and death, stillbirth, neonatal hypotension, prolonged hypotonicity, and respiratory morbidity (p<0.01). Although mean incision to delivery time was faster for women undergoing GA (6.2 mins vs. 10.7 mins; p<0.001), mean neonatal umbilical cord pH was lower (7.21 vs. 7.24; p<0.001). When emergent cesareans were excluded (n=365), a multilogistic regression model demonstrated that exposure to GA vs. other types of anesthesia was an independent predictor of 5 minute Apgar score <5 (p<0.01), as was delivery at <32 weeks. In a second model including only women who received GA for non-emergent cesarean deliveries, prolonged incision-to-delivery time (> 18 mins) was an independent predictor of 5 minute Apgar scores of < 5 (p=0.037). Multiple maternal and neonatal effects exist from the use of general anesthesia. Shortening the incision to delivery time may improve neonatal outcomes." @default.
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- W1963921922 date "2013-01-01" @default.
- W1963921922 modified "2023-10-05" @default.
- W1963921922 title "672: General anesthesia at cesarean delivery portends worse maternal and neonatal outcomes" @default.
- W1963921922 doi "https://doi.org/10.1016/j.ajog.2012.10.838" @default.
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