Clinical evaluation of anesthesia for cesarean section of the patients with hypertensive disorders in pregnancy: retrospective study for 10 years |
Eun Chi Bang, Hyun Sook Lee, Yong In Kang, Kyung Sook Cho, Su Yeon Kim, Jun Young Kim |
Department of Anesthesiology and Pain Medicine, College of Medicine, CHA University, Seoul, Korea. ecbang63@hanmail.net |
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Abstract |
BACKGROUND There are many difficulties in anesthetic management for cesarean section of the patients with hypertension.The anesthetic management of hypertensive disorders in pregnancy has been controversial. METHODS: We reviewed the medical records of the patients with hypertensive disorders in pregnancy from Jan., 1998 to Dec., 2007, and made clinical analysis of the anesthesia for cesarean section. RESULTS: Of the total 775 parturients with hypertensive disorders, 638 (82.3%) was delivered by cesarean section.Indications for cesarean section were, in order of frequency, hypertensive disorders in pregnancy (36.9%), multiple pregnancy (13.8%), previous cesarean section (11.6%), etc.Of the total cesarean section, 468 (73.4%) were emergency cases.The majority of preoperative systolic blood pressures were 141-160 mmHg (36.2%) and 161-180 mmHg (35.2%). The majority of preoperative diastolic blood pressures were 91-100 mmHg (28.6%) and 101-110 mmHg (25.0%). 350 (54.9%) had epidural anesthesia, 195 (30.5%) had general anesthesia, and 93 (14.6%) had spinal anesthesia.Estimated blood loss was significantly lower after regional anesthesia than after general anesthesia.In patients received magnesium sulfate (MgSO4), (40.0% of total) 83.5% had regional anesthesia and 16.5% had general anesthesia.In the cases with MgSO4 1 min Apgar score was lower and neonatal birth weight was smaller than in cases without MgSO4. CONCLUSIONS: Anesthesiologist must have much attention on the prevention, treatment and anesthetic management for cesarean section of patients with hypertensive disorders in pregnancy. |
Key Words:
Cesarean section, Epidural anesthesia, General anesthesia, Hypertensive disorders in pregnancy, Spinal anesthesia |
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