General Anesthesia for Cesarean Section, Maternal and Perinatal Outcomes

Anesthesia Clinical Trial

Official title:

General Anesthesia in Obstetric Patients for Cesarean Section, Maternal and Perinatal Outcomes

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT06160583
• Other study ID #: 257/23
• Status: Active, not recruiting
• Start date: November 12, 2023
• Est. completion date: January 31, 2024

Study information

• Verified date: November 2023
• Source: Hospital Civil de Guadalajara
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational [Patient Registry]

Clinical Trial Summary

To evaluate the maternal and perinatal outcomes that occur in obstetric patients undergoing cesarean section surgery under general anesthesia at the Fray Antonio Alcalde Civil Hospital of Guadalajara.

Description:

Pregnant patients who required surgical management to resolve the pregnancy via the abdominal route will be identified from the anesthesiology logs and evaluation sheets of the obstetric patient. During the period from January 2019 to December 2023.

The data will be collected in a database made up of Excel software. Maternal data collected:Of the total cesarean surgery procedures, the following are collected: hospital record, the anesthetic technique administered and the date of the surgical intervention.

Patients who underwent surgery under general anesthesia technique will be identified and their demographic data will be recorded (name, age, hospital record, weight, height, BMI, obstetric data, number of pregnancies, births, cesarean sections, abortions, weeks of gestation) diagnosis. , type of intervention, procedure performed The characteristics of the anesthetic technique, the drugs used for anesthetic induction, will also be recorded.

Complications associated with the anesthetic technique will be recorded, such as:

intraoperative awakening, failed tracheal intubation and pulmonary aspiration.

The status of the patient's discharge from the operating room, extubated or intubated, will be recorded.

Fetal data collected: Prenatal fetal diagnosis will be obtained, as well as its classification by ultrasound measurement of estimated weight and weeks of gestation assigned to weight appropriate for gestational age, small for gestational age or large for gestational age.

From the results of the newborn, the condition at birth, weight, height, gestational age, as well as the size at birth assigned in: adequate weight, low or high, are recorded.

The Apgar score will be obtained at one minute and at 5 minutes. The condition of the newborn after immediate care will be recorded if he or she remains in rooming-in or is discharged to surveillance, intermediate or intensive therapy.

Data that is not found in the obstetric patient's evaluation sheets will be corroborated in anesthesiology, nursing, neonatology logs and electronic records. Once the database is obtained, the statistical analysis will be carried out.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 5000
• Est. completion date: January 31, 2024
• Est. primary completion date: November 12, 2023
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 14 Years to 45 Years

Eligibility

Inclusion Criteria:

• Obstetric patients who require surgical intervention to resolve the pregnancy, under general anesthesia

Exclusion Criteria:

• Obstetric patients who enter the hospital intubated.

Related Conditions & MeSH terms

• Anesthesia
• Maternal-Fetal Relations
• Perinatal Morbidity

Locations

Country	Name	City	State
Mexico	Maria de Los Angeles Campechano Ascencio	Guadalajara	Jalisco

Sponsors (1)

Lead Sponsor	Collaborator
Hospital Civil de Guadalajara

Country where clinical trial is conducted

Mexico, 

References & Publications (52)

Al Rifai RH. Trend of caesarean deliveries in Egypt and its associated factors: evidence from national surveys, 2005-2014. BMC Pregnancy Childbirth. 2017 Dec 13;17(1):417. doi: 10.1186/s12884-017-1591-2. — View Citation

Al-Husban N, Elmuhtaseb MS, Al-Husban H, Nabhan M, Abuhalaweh H, Alkhatib YM, Yousef M, Aloran B, Elyyan Y, Alghazo A. Anesthesia for Cesarean Section: Retrospective Comparative Study. Int J Womens Health. 2021 Feb 2;13:141-152. doi: 10.2147/IJWH.S292434. — View Citation

Aydas AD, Basaranoglu G, Ozdemir H, Dooply SL, Muhammedoglu N, Kucuk S, Saidoglu L. Airway changes in pregnant women before and after delivery. Ir J Med Sci. 2015 Jun;184(2):431-3. doi: 10.1007/s11845-014-1138-8. Epub 2014 May 24. — View Citation

Bavenas E, Moller C, Bhandarkar P, Mulowooza J, Lofgren J. Predictors of immediate neonatal outcome after cesarean section in Uganda. Int J Gynaecol Obstet. 2022 Jul;158(1):101-109. doi: 10.1002/ijgo.13986. Epub 2021 Nov 8. — View Citation

Betran AP, Ye J, Moller AB, Zhang J, Gulmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One. 2016 Feb 5;11(2):e0148343. doi: 10.1371/journal.pone.0148343. eCollection 2016. — View Citation

Bonhomme V, Staquet C, Montupil J, Defresne A, Kirsch M, Martial C, Vanhaudenhuyse A, Chatelle C, Larroque SK, Raimondo F, Demertzi A, Bodart O, Laureys S, Gosseries O. General Anesthesia: A Probe to Explore Consciousness. Front Syst Neurosci. 2019 Aug 14 — View Citation

Bowring J, Fraser N, Vause S, Heazell AE. Is regional anaesthesia better than general anaesthesia for caesarean section? J Obstet Gynaecol. 2006 Jul;26(5):433-4. doi: 10.1080/01443610600720345. — View Citation

Butwick AJ, Palanisamy A. Mode of anaesthesia for Caesarean delivery and maternal morbidity: can we overcome confounding by indication? Br J Anaesth. 2018 Apr;120(4):621-623. doi: 10.1016/j.bja.2018.01.002. Epub 2018 Feb 14. No abstract available. — View Citation

Cobb BT, Lane-Fall MB, Month RC, Onuoha OC, Srinivas SK, Neuman MD. Anesthesiologist Specialization and Use of General Anesthesia for Cesarean Delivery. Anesthesiology. 2019 Feb;130(2):237-246. doi: 10.1097/ALN.0000000000002534. — View Citation

Committee Opinion No. 644: The Apgar Score. Obstet Gynecol. 2015 Oct;126(4):e52-e55. doi: 10.1097/AOG.0000000000001108. — View Citation

D'Angelo R, Smiley RM, Riley ET, Segal S. Serious complications related to obstetric anesthesia: the serious complication repository project of the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2014 Jun;120(6):1505-12. doi: 10.1097/AL — View Citation

Dahlke JD, Mendez-Figueroa H, Rouse DJ, Berghella V, Baxter JK, Chauhan SP. Evidence-based surgery for cesarean delivery: an updated systematic review. Am J Obstet Gynecol. 2013 Oct;209(4):294-306. doi: 10.1016/j.ajog.2013.02.043. Epub 2013 Mar 1. — View Citation

Dallmann A, Ince I, Meyer M, Willmann S, Eissing T, Hempel G. Gestation-Specific Changes in the Anatomy and Physiology of Healthy Pregnant Women: An Extended Repository of Model Parameters for Physiologically Based Pharmacokinetic Modeling in Pregnancy. C — View Citation

Delgado C, Ring L, Mushambi MC. General anaesthesia in obstetrics. BJA Educ. 2020 Jun;20(6):201-207. doi: 10.1016/j.bjae.2020.03.003. Epub 2020 Apr 21. No abstract available. — View Citation

Detsky ME, Jivraj N, Adhikari NK, Friedrich JO, Pinto R, Simel DL, Wijeysundera DN, Scales DC. Will This Patient Be Difficult to Intubate?: The Rational Clinical Examination Systematic Review. JAMA. 2019 Feb 5;321(5):493-503. doi: 10.1001/jama.2018.21413. — View Citation

Devroe S, Van de Velde M, Rex S. General anesthesia for caesarean section. Curr Opin Anaesthesiol. 2015 Jun;28(3):240-6. doi: 10.1097/ACO.0000000000000185. — View Citation

Elnakib S, Abdel-Tawab N, Orbay D, Hassanein N. Medical and non-medical reasons for cesarean section delivery in Egypt: a hospital-based retrospective study. BMC Pregnancy Childbirth. 2019 Nov 8;19(1):411. doi: 10.1186/s12884-019-2558-2. — View Citation

Franks NP. General anaesthesia: from molecular targets to neuronal pathways of sleep and arousal. Nat Rev Neurosci. 2008 May;9(5):370-86. doi: 10.1038/nrn2372. — View Citation

Garcia-Alix Perez A. [Non-reassuring fetal status, perinatal asphyxia and neonatal encephalopathy]. An Pediatr (Barc). 2005 Jul;63(1):1-4. doi: 10.1157/13076760. No abstract available. Spanish. — View Citation

Guglielminotti J, Landau R, Li G. Adverse Events and Factors Associated with Potentially Avoidable Use of General Anesthesia in Cesarean Deliveries. Anesthesiology. 2019 Jun;130(6):912-922. doi: 10.1097/ALN.0000000000002629. — View Citation

Hassanin AS, El-Shahawy HF, Hussain SH, Bahaa Eldin AM, Elhawary MM, Elbakery M, Elsafty MSE. Impact of interval between induction of spinal anesthesia to delivery on umbilical arterial cord ph of neonates delivered by elective cesarean section. BMC Pregn — View Citation

Hollowell J, Pillas D, Rowe R, Linsell L, Knight M, Brocklehurst P. The impact of maternal obesity on intrapartum outcomes in otherwise low risk women: secondary analysis of the Birthplace national prospective cohort study. BJOG. 2014 Feb;121(3):343-55. d — View Citation

Husarova V, McCaul CL. Incidence of general anaesthesia for caesarean section in parturients from different geographic regions: 7-year retrospective study in a single European university centre. Eur J Anaesthesiol. 2016 Jun;33(6):466-8. doi: 10.1097/EJA.0 — View Citation

Ikeda T, Kato A, Bougaki M, Araki Y, Ohata T, Kawashima S, Imai Y, Ninagawa J, Oba K, Chang K, Uchida K, Yamada Y. A retrospective review of 10-year trends in general anesthesia for cesarean delivery at a university hospital: the impact of a newly launche — View Citation

Jain K, Gupta N, Yadav M, Thulkar S, Bhatnagar S. Radiological evaluation of airway - What an anaesthesiologist needs to know! Indian J Anaesth. 2019 Apr;63(4):257-264. doi: 10.4103/ija.IJA_488_18. — View Citation

Juang J, Gabriel RA, Dutton RP, Palanisamy A, Urman RD. Choice of Anesthesia for Cesarean Delivery: An Analysis of the National Anesthesia Clinical Outcomes Registry. Anesth Analg. 2017 Jun;124(6):1914-1917. doi: 10.1213/ANE.0000000000001677. — View Citation

Kodali BS, Chandrasekhar S, Bulich LN, Topulos GP, Datta S. Airway changes during labor and delivery. Anesthesiology. 2008 Mar;108(3):357-62. doi: 10.1097/ALN.0b013e31816452d3. — View Citation

Lumbiganon P, Moe H, Kamsa-Ard S, Rattanakanokchai S, Laopaiboon M, Kietpeerakool C, Jampathong N, Somjit M, Cecatti JG, Vogel JP, Betran AP, Mittal S, Torloni MR. Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-in — View Citation

Maronge L, Bogod D. Complications in obstetric anaesthesia. Anaesthesia. 2018 Jan;73 Suppl 1:61-66. doi: 10.1111/anae.14141. — View Citation

McGuire B, Lucas DN. Planning the obstetric airway. Anaesthesia. 2020 Jul;75(7):852-855. doi: 10.1111/anae.14987. Epub 2020 Mar 6. No abstract available. — View Citation

McNarry AF, Patel A. The evolution of airway management - new concepts and conflicts with traditional practice. Br J Anaesth. 2017 Dec 1;119(suppl_1):i154-i166. doi: 10.1093/bja/aex385. — View Citation

Metogo JAM, Nana TN, Ngongheh BA, Nyuydzefon EB, Adjahoung CA, Tochie JN, Minkande JZ. General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study. BMC Anesthesiol. 2021 Mar 4;21(1):68. doi: — View Citation

Mhyre JM, Sultan P. General Anesthesia for Cesarean Delivery: Occasionally Essential but Best Avoided. Anesthesiology. 2019 Jun;130(6):864-866. doi: 10.1097/ALN.0000000000002708. No abstract available. — View Citation

Munnur U, de Boisblanc B, Suresh MS. Airway problems in pregnancy. Crit Care Med. 2005 Oct;33(10 Suppl):S259-68. doi: 10.1097/01.ccm.0000183502.45419.c9. Erratum In: Crit Care Med. 2006 Jan;34(1):273. — View Citation

Munro A, Sjaus A. General anesthesia for Cesarean delivery: can interinstitutional variation in practice offer deeper insights into our choice of anesthetic modality? Can J Anaesth. 2023 Nov 6. doi: 10.1007/s12630-023-02634-9. Online ahead of print. No ab — View Citation

Mushambi MC, Kinsella SM, Popat M, Swales H, Ramaswamy KK, Winton AL, Quinn AC; Obstetric Anaesthetists' Association; Difficult Airway Society. Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult an — View Citation

Neef V, Wenk M, Kranke P. [Obstetric Anesthesia]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2023 Oct;58(10):570-582. doi: 10.1055/a-2043-4329. Epub 2023 Oct 13. German. — View Citation

Ozden MGN, Koruk S, Collak Z, Panik N. Comparison of the effects of general and spinal anesthesia for cesarean delivery on maternal and fetal outcomes: A retrospective analysis of data. North Clin Istanb. 2023 Sep 11;10(5):575-582. doi: 10.14744/nci.2023. — View Citation

Preston R, Jee R. Obstetric airway management. Int Anesthesiol Clin. 2014 Spring;52(2):1-28. doi: 10.1097/AIA.0000000000000014. No abstract available. — View Citation

Ring L, Landau R, Delgado C. The Current Role of General Anesthesia for Cesarean Delivery. Curr Anesthesiol Rep. 2021;11(1):18-27. doi: 10.1007/s40140-021-00437-6. Epub 2021 Feb 24. — View Citation

Robbins LS, Blanchard CT, Biasini FJ, Powell MF, Casey BM, Tita AT, Harper LM. General anesthesia for cesarean delivery and childhood neurodevelopmental and perinatal outcomes: a secondary analysis of a randomized controlled trial. Int J Obstet Anesth. 20 — View Citation

Sajayan A, Wicker J, Ungureanu N, Mendonca C, Kimani PK. Current practice of rapid sequence induction of anaesthesia in the UK - a national survey. Br J Anaesth. 2016 Sep;117 Suppl 1:i69-i74. doi: 10.1093/bja/aew017. Epub 2016 Feb 24. — View Citation

Salomon LJ, Alfirevic Z, Da Silva Costa F, Deter RL, Figueras F, Ghi T, Glanc P, Khalil A, Lee W, Napolitano R, Papageorghiou A, Sotiriadis A, Stirnemann J, Toi A, Yeo G. ISUOG Practice Guidelines: ultrasound assessment of fetal biometry and growth. Ultra — View Citation

Sanghavi M, Rutherford JD. Cardiovascular physiology of pregnancy. Circulation. 2014 Sep 16;130(12):1003-8. doi: 10.1161/CIRCULATIONAHA.114.009029. No abstract available. — View Citation

Schatz M, Dombrowski MP. Clinical practice. Asthma in pregnancy. N Engl J Med. 2009 Apr 30;360(18):1862-9. doi: 10.1056/NEJMcp0809942. No abstract available. — View Citation

Siddik-Sayyid S, Zbeidy R. Practice guidelines for obstetric anesthesia--a summary. Middle East J Anaesthesiol. 2008 Oct;19(6):1291-303. No abstract available. — View Citation

Silva JC, Amaral AR, Ferreira BD, Petry JF, Silva MR, Krelling PC. [Obesity during pregnancy: gestational complications and birth outcomes.]. Rev Bras Ginecol Obstet. 2014 Nov;36(11):509-513. doi: 10.1590/s0100-720320140005024. Epub 2014 Nov 1. Portuguese — View Citation

Sumikura H, Niwa H, Sato M, Nakamoto T, Asai T, Hagihira S. Rethinking general anesthesia for cesarean section. J Anesth. 2016 Apr;30(2):268-73. doi: 10.1007/s00540-015-2099-4. Epub 2015 Nov 19. — View Citation

Sung S, Mahdy H. Cesarean Section. 2023 Jul 9. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK546707/ — View Citation

Swanson K, Liang L, Grobman WA, Higgins N, Roy A, Son M. Duration of Exposure to General Endotracheal Anesthesia during Cesarean Deliveries at Term and Perinatal Complications. Am J Perinatol. 2022 Feb;39(3):232-237. doi: 10.1055/s-0041-1739355. Epub 2021 — View Citation

Wise RA, Polito AJ, Krishnan V. Respiratory physiologic changes in pregnancy. Immunol Allergy Clin North Am. 2006 Feb;26(1):1-12. doi: 10.1016/j.iac.2005.10.004. — View Citation

Zhu T, Tang J, Zhao F, Qu Y, Mu D. Association between maternal obesity and offspring Apgar score or cord pH: a systematic review and meta-analysis. Sci Rep. 2015 Dec 22;5:18386. doi: 10.1038/srep18386. — View Citation

* Note: There are 52 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Frequency general anesthesia	Obtain the frequency of obstetric patients undergoing cesarean section surgery under general anesthesia	5 years
Primary	Maternal and fetal diagnosis	Specify the diagnoses for which general anesthesia is carried out	5 years
Primary	Classification physical status	Know the physical status of patients undergoing cesarean surgery	5 years
Primary	General anesthesia complications	Identify complications of the anesthetic technique	5 years
Primary	Maternal condition at the end of surgery	List the maternal discharge condition at the end of surgery (intubated/extubated)	5 years
Primary	Anesthetic induction	Describe the medications used for anesthetic induction	5 years
Primary	Prenatal classification by weight and gestational age	Document prenatal classification of the fetus by weight and gestational age assigned by ultrasound	5 years
Primary	Apgar Score	Record the newborn's Apgar score	5 years
Primary	Size at birth	Document birth size classification assigned by neonatology	5 years
Primary	Condition of the newborn	List the condition of the newborn after his or her initial evaluation (rooming-in/neonatal therapy)	5 years