Maternal and neonatal outcome following caesarean section under spinal versus general Anesthesia in Kenyatta National Hospital maternity theatre

Abstract

The risk of maternal death with caesarean section is four times that associated with all types of vaginal Birth. Poor maternal and neonatal outcome are more commonly associated with general anesthesia for cis as compared to spinal anesthesia. This study compared the safety and the effectiveness of the two techniques for maternal and neonatal outcome for all the indications for caesarean section Methodology: A Prospective Observational Descriptive study carried out in KNH maternity theater. A total of 196 patients were recruited in this study and they all completed the study. Results In this study, of 196 patients, 43.9% cis were performed under GA. The rest were under SA regardless of the indication for the cis. The preference of anesthesia for cis was directed at SA regardless of the indication and was significant (p=0.032). From the data, SAwas performed in 40.8%, whilst GA 59.2% in a group of patients with immediate indications for cis. For patients who had urgent indications for cis, SA was performed in 60.8% out of 102 cases. SA was a predominant choice with elective indications. Out of 35 cases, 24 cases were performed under SA and 11 cases under GA. Intra-operatively, the commonest maternal side effect observed from the two groups was Hypotension and was significant in the SA group (p<0.001). The total number of cases that got hypotension in SA group was 52 (47.3%) and in the GA group, 12(14%).