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KMID : 1155520090040040342
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Anesthesia and Pain Medicine
2009 Volume.4 No. 4 p.342 ~ p.347
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Clinical evaluation of anesthesia for cesarean section of the patients with hypertensive disorders in pregnancy:retrospective study for 10 years
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Bang Eun-Chi
Lee Hyun-Sook
Kang Yong-In
Cho Kyung-Sook
Kim Su-Yeon
Kim Jun-Young
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Abstract
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Background:There are many difficulties in anesthetic management for cesarean section of the patients with hypertension.The anesthetic management of hypertensive disorders in pregnancy has been controversial.
Methods:We reviewed the medical records of the patients with hypertensive disorders in pregnancy from Jan., 1998 to Dec., 2007, and made clinical analysis of the anesthesia for cesarean section.
Results:Of the total 775 parturients with hypertensive disorders, 638 (82.3%) was delivered by cesarean section.Indications for cesarean section were, in order of frequency, hypertensive disorders in pregnancy (36.9%), multiple pregnancy (13.8%), previous cesarean section (11.6%), etc.Of the total cesarean section, 468 (73.4%) were emergency cases.The majority of preoperative systolic blood pressures were 141?160 mmHg (36.2%) and 161?180 mmHg (35.2%).The majority of preoperative diastolic blood pressures were 91?100 mmHg (28.6%) and 101?110 mmHg (25.0%).350 (54.9%) had epidural anesthesia, 195 (30.5%) had general anesthesia, and 93 (14.6%) had spinal anesthesia.Estimated blood loss was significantly lower after regional anesthesia than after general anesthesia.In patients received magnesium sulfate (MgSO4), (40.0% of total) 83.5% had regional anesthesia and 16.5% had general anesthesia.In the cases with MgSO4 1 min Apgar score was lower and neonatal birth weight was smaller than in cases without MgSO4.
Conclusions:Anesthesiologist must have much attention on the prevention, treatment and anesthetic management for cesarean section of patients with hypertensive disorders in pregnancy.
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KEYWORD
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Cesarean section, Epidural anesthesia, General anesthesia, Hypertensive disorders in pregnancy, Spinal anesthesia.
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