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KMID : 1155520160110010049
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Anesthesia and Pain Medicine
2016 Volume.11 No. 1 p.49 ~ p.54
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Clinical evaluation of anesthesia for cesarean section at tertiary medical center: retrospective study for 5 years (2009-2013)
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Park Sang-Hee
Kim Dong-Jun
Kim Woon-Young
Kim Jae-Hwan
Lee Yoon-Sook
Park Young-Cheol
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Abstract
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Background: Cesarean section anesthesia requires adequate preparation because of maternal physiologic changes, a higher risk for massive maternal bleeding, neonatal considerations, and a higher frequency of emergency operations. Therefore, we retrospectively compared clinical outcomes of cesarean section patients between a high-risk group and non-high-risk group in order to improve anesthesia care.
Methods: We reviewed medical records from cesarean section cases at our tertiary medical center for 5 years (2009?2013). Parameters included the anesthesia and operative time; estimated blood loss, fluid volume and blood products administered during surgery, additional administration of maternal uterotonic medications; as well as the birth weight, Apgar scores, number of neonatal intensive care unit (NICU) admissions, and stillbirth rates of the neonate.
Results: The total number of delivery cases was 1935 during the 5 years, and the cesarean section cases accounted for 58.8% (1,138 cases). There were 735 emergency surgery cases (64.6%), and 813 (71.4%) patients were in the high-risk group. Estimated blood loss, fluid volume used, and the frequency and amount of blood transfusions were statistically higher in the high-risk group. Among 1,243 neonates, 918 (73.9%) were born from high-risk mothers. Neonatal birth weights and Apgar scores (1 and 5 minutes) from patients in the high-risk group were statistically lower than those in the non-high-risk group, and NICU admissions and stillbirths were statistically higher in the high-risk group.
Conclusions: Anesthesiologists should be aware of unfavorable clinical outcomes in high-risk cesarean section groups and carefully prepare for anesthesia care in these cases.
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KEYWORD
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Cesarean section, High-risk delivery, Obstetric anesthesia
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