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अमूर्त

Maternal and Neonatal outcomes in mothers who undergo caesarean section under General and spinal Anesthesia in Gandhi Memorial Hospital, Addis Ababa

Semagn Mekonen, Akine Eshete, Kokeb Desta and

Background: Types of anesthesia and perioperative patient cares are the main determinants of maternal and neonatal outcomes in mothers undergo caesarean section. Body of evidence revealed that maternal and neonatal outcomes were better in mothers who gave birth under spinal anesthesia than general anesthesia. However evidences are lacking locally, hence, this study aimed to compare maternal and neonatal outcomes in mothers who undergo caesarean section under general anesthesia and spinal anesthesia.

Methods: A prospective Cohort study was conducted in Gandhi Memorial Hospital among mothers, who undergo cesarean section under spinal and general anesthesia from March to July, 2014. One hundred and twenty Mothers were followed for twenty four hours period. Statistical Package for Social Sciences version 16 was used to perform descriptive and logistic regression analyses. Statistical significance was set at P-value <0.05 to judge the association.

Results: The total response rate of the study was 120 (100 %). The study revealed that types of anesthesia were independent predictor of maternal and neonatal outcomes. Mothers who underwent caesarean section under spinal were more likely to have postoperative nausea and vomiting (COR=38.5, 95% CI=(12,123). Incidence of low Apgar score in first minute was two and half times more likely to occur in general anesthesia, (AOR=2.54, 95% CI=(1.26, 25.4). The first analgesic request in mothers underwent caesarean section under spinal anesthesia was three times more than mothers underwent caesarean section under general anesthesia (AOR=3.4, 95%CI=(1.4, 6.7)

Conclusion: Spinal anesthesia was associated with high incidence of postoperative nausea and vomiting and hypotension. But first minute Apgar score and first time analgesic request were better in spinal analgesia. General anesthesia was associated with high estimated blood loss, shorter time to first analgesic request and lower first minute Apgar score. Appropriate perioperative patient care by anesthetist and provision of drugs for treatment of hypotension were recommended.