Anesthesia Clinical Trial
Official title:
Incidence of Complications Associated With Anesthesia in Multiple Gestation Undergoing Cesarean Delivery: A Retrospective Review
Incidence of anesthesia related complications in multiple gestation patients undergoing cesarean delivery has not been reported in Thailand. The aim of this study is to identify complications that occur which may derived from different anesthetic techniques used, such as hypotension, uterine atony, postpartum hemorrhage, rate of hysterectomy, blood transfusion and fetal outcome.
Nowadays, the rate of multiple gestations is increasing considerably due to the prevalence of
assisted reproductive technology. As physiologic changes from multiple gestations differ from
singleton pregnancy, multiple gestations are considered a high risk pregnancy. A number of
complications can occur from prenatal period such as preterm labor and increase rate of
maternal beta agonist usage e.g. ritodrine, terbutaline and salbutamol. These drugs cause
maternal tachycardia, hypokalemia and pulmonary edema. Multiple gestations increase rate of
cesarean delivery and intraoperative complications such as postpartum hemorrhage and
hysterectomy can be found 3.7 times and 2.3 times respectively higher than that of singleton
pregnancy.
Spinal anesthesia is the anesthetic technique of choice for parturients undergoing cesarean
section, owing to its rapid onset of action, reliability, superior postoperative pain control
and lower mortality rate than general anesthesia. However, the most important complication is
maternal hypotension, especially in multiple gestations that may derive from more aortocaval
compression comparing with singleton pregnancy. Nevertheless, some patients having
contraindications for regional anesthesia e.g. thrombocytopenia, coagulopathy or pulmonary
edema make anesthesiologists decide to put these patients under general anesthesia for
cesarean section. General anesthesia for cesarean section in singleton pregnancy has been
proved that can cause higher incidence of postpartum hemorrhage and higher rate of blood
transfusion compared to regional anesthesia.
Incidence of anesthesia related complications in multiple gestation patients undergoing
cesarean delivery has not been reported in Thailand. The aim of this study is to identify
complications that occur which may derived from different anesthetic techniques used, such as
hypotension, uterine atony, postpartum hemorrhage, rate of hysterectomy, blood transfusion
and fetal outcome.
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