The Effect Of Anesthetic Technique On Fetal Outcome Among Mothers Undergoing Caesarean Section For Non-Reassuring Fetal Status At Addis Ababa Public Hospitals, Addis Ababa Ethiopia
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Date
2020-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: Emergency Cesarean Sections are performed for various reasons. One of the
reasons to do Cesarean Section (CS) is non-reassuring fetal status. Cases with emergency
caesarean sections like non-reassuring fetal status are challenging for the obstetric anesthetist and
obstetrician because such cases are highly associated with life-threatening complications for the
fetus and/or the mother. So, choosing appropriate anesthetic technique in such cases is essential
in decreasing fetal and maternal morbidity and mortality.
Objective: To assess the effects of anesthetic technique, General Anesthesia (GA) versus Spinal
Anesthesia (SA), over neonatal outcome of newborns delivered by CS for the indication of nonreassuring
fetal
status
in
Addis
Ababa
government
hospitals,
in
2019/2020
Methods:
A
prospective
cohort
study
was
conducted
on
200
pregnant
mothers
who
came
for
CS
for
the indication of non-reassuring fetal status and fulfill the inclusion criteria for the study.
Patients in SA group (n = 100) received spinal anesthesia with 10 mg of bupivacaine while the
GA group (n = 100) received general anesthesia. Study participants were selected by systematic
random sampling technique after proportional allocation to the study hospitals. Data were
collected using preoperative chart review, maternal interview and intraoperative observation.
Comparisons of numerical variables between study groups were done using independent sample
t-test and categorical variables were performed using chi-square test. Significance was
determined at p-value < 0.05.
Results: There was a significant difference in the mean of 1 minute Apgar score between SA and
GA groups among newborns delivered by caesarean section for the indication of non-reassuring
fetal heart status (Mean = 7.28, SD = 1.16) and (M = 6.64, SD = 1.44; p = 0.001) for SA and GA
respectively. But there was no significant difference in 5 minute Apgar score. There was no
significant difference in neonatal intensive care unit admission between GA and SA groups, χ2
(1) = 0.31, p =0.57.
Conclusions: this study revealed that newborns delivered under SA had better 1 minute mean
Apgar score when compared with GA. Based on this we recommend SA for mothers with the
diagnosis of non-reassuring fetal status.
Description
Keywords
Non-reassuring fetal status, general anesthesia Spinal anesthesia, Ethiopia.