C E Aiken1, A R Aiken2, J C Cole1, J C Brockelsby1, J H Bamber3. 1. Department of Obstetrics and Gynaecology, University of Cambridge, Addenbrooke's Hospital, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, UK. 2. Office of Population Research, Wallace Hall, Princeton University, Princeton, NJ, USA. 3. Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, UK.
Abstract
OBJECTIVE: To investigate risk factors predicting unplanned conversion to general anesthesia during elective cesarean section, and to examine maternal and fetal outcomes associated with unplanned conversion compared with other modes of anesthesia. STUDY DESIGN: A retrospective cohort at a UK center (2008 to 2013). Women (4337) underwent elective cesarean section. Delivery outcomes were compared according to anesthesia type using logistic regression. RESULT: Women (1.6%) underwent unplanned conversion to general anesthetic. Unplanned conversion was associated with higher parity (odds ratio (OR) 3.82, confidence interval (CI; (1.58 to 9.62)) and maternal age ⩾40 (OR 4.40, CI (1.08 to 29.88)). Compared with spinal anesthetic, unplanned conversion was associated with increased likelihood of maternal hemorrhage ⩾1.5 l (OR 5.74, CI (1.90 to 14.01)) and delayed neonatal respiration (OR 4.76, CI (1.76 to 11.05)). Adverse outcomes were not significantly more likely compared with planned general anesthetic. CONCLUSION: Higher parity and maternal age are risk factors for unplanned conversion to general anesthetic. There is no increase in the likelihood of adverse outcomes with unplanned versus planned general anesthetic.
OBJECTIVE: To investigate risk factors predicting unplanned conversion to general anesthesia during elective cesarean section, and to examine maternal and fetal outcomes associated with unplanned conversion compared with other modes of anesthesia. STUDY DESIGN: A retrospective cohort at a UK center (2008 to 2013). Women (4337) underwent elective cesarean section. Delivery outcomes were compared according to anesthesia type using logistic regression. RESULT: Women (1.6%) underwent unplanned conversion to general anesthetic. Unplanned conversion was associated with higher parity (odds ratio (OR) 3.82, confidence interval (CI; (1.58 to 9.62)) and maternal age ⩾40 (OR 4.40, CI (1.08 to 29.88)). Compared with spinal anesthetic, unplanned conversion was associated with increased likelihood of maternal hemorrhage ⩾1.5 l (OR 5.74, CI (1.90 to 14.01)) and delayed neonatal respiration (OR 4.76, CI (1.76 to 11.05)). Adverse outcomes were not significantly more likely compared with planned general anesthetic. CONCLUSION: Higher parity and maternal age are risk factors for unplanned conversion to general anesthetic. There is no increase in the likelihood of adverse outcomes with unplanned versus planned general anesthetic.
Authors: Alfredo Mancuso; Antonio De Vivo; Annamaria Giacobbe; Valentina Priola; Laura Maggio Savasta; Marianna Guzzo; Dominique De Vivo; Alba Mancuso Journal: J Matern Fetal Neonatal Med Date: 2010-10
Authors: V Liberis; P Tsikouras; T Vogiatzaki; A Savidis; A Ammari; Ch Iatrou; G Maroulis Journal: Clin Exp Obstet Gynecol Date: 2009 Impact factor: 0.146