A Single-center Retrospective Cohort Study on Cesarean Section under General Anesthesia

来源 :中国医学科学杂志(英文版) | 被引量 : 0次 | 上传用户:dazhonghua988
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Objective Neuraxial block is the most common anesthesia method for cesarean section (CS). However, for some urgent and high-risk cesarean delivery, general anesthesia (GA) also plays a very important role.We aimed to find out the reasons of choosing GA for CS in our center and the factors that may be related to the matal and fetal outcomes. Methods We retrospectively selected parturients who had CS procedures under GA in Peking Union Medical College Hospital from January 1, 2014 to December 31, 2016. Clinical data (baseline matal status, preoperative status, perioperative information, matal and fetal outcomes) of parturients and neonates were collected and analyzed. We summarized the common reasons for applying general anesthesia, and compared the back-to-ICU ratio and hospital stay time between parturients with different matal American Society of Anesthesiologists (ASA) grade, gestational weeks and intraoperative blood loss, as well as the fetal one-minute Apgar score between different matalASA grade and gestational weeks. Results There were 98 cases of CS under GA enrolled in the study. Among the matal and fetal factors, pregnancy with intal or surgical diseases is the most common reason (59 cases, 60.2%) for choosing GA, followed by the placenta and fetal membrane abnormalities (38 cases, 38.8%) and the pregnancy-specific disorders (36 cases, 36.7%).ASA grade Ⅲ-Ⅳ of parturients (χ2=44.3, P<0.05), gestation period < 37 weeks (χ2=23.4, P<0.05), and blood loss > 800 ml (χ2=5.5, P<0.05) were related to the higher postoperative intensive care unit (ICU) rate in parturients. ASA grade Ⅲ-Ⅳ of parturients (t=-2.99, P<0.05), gestation period < 37 weeks (t=2.47, P<0.05) were related to the longer hospital stay.ASA grade Ⅲ-Ⅳ of parturients (t=2.21, P=0.01) and gestation period < 37 weeks (t=-3.21, P=0.002) were related to the lower one-minuteApgar score of neonates. Conclusion Pregnancy with intal or surgical diseases is the most common reason for choosing GA for CS. High ASA grade and short gestation period were the related factors of high postoperative ICU ratio for parturients and low one-minuteApgar score for neonates.
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