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Indications and Newborn Outcomes of 705 Parturients Undergoing Cesarean Delivery with General Anesthesia: Retrospective Review of Labor and Delivery Data in A Major Tertiary Teaching Hospital in China
Abstract Number: SAT-54
Abstract Type: Original Research
Recent data revealed improved overall cesarean rate in mainland China. However, in October 2015, the Chinese government abolished the one-child policy. We have been experiencing a surge of cesarean delivery at a major tertiary teaching hospital. In addition, an increased rate of general anesthesia was induced for these cases. We conducted this study to review the indications and outcomes of these cases.
Medical records of patients underwent cesarean delivery under general anesthesia or neuraxial anesthesia at Qilu Hospital of Shangdong University from January 2013 to December 2016 were reviewed. Data of comorbidities, causes for general anesthesia and Apgar scores of their newborns were collected and analyzed.
From January 2013 to December 2016, the annual number (and rate) of cesarean deliveries were 1962 (55.5%), 2660 (54.1%), 1977 (58.1%) and 3060 (57.1%), respectively. During the aforementioned period, a total of 705 (7.3%) parturients underwent cesarean delivery under general anesthesia, while 8954 (92.7%) parturients were performed under neuraxial anesthesia. (Figure 1a, b) The indications for general anesthesia include central nervous diseases (7, 1.0%), hematological diseases (133, 18.9%), obstetric related indications (503, 71.3%), immunological diseases (26, 3.7%) and unknown reasons (36, 5.1%). With regards to the obstetric related indications: HELLP (71, 14.1%), acute fatty liver (49, 9.7%), placenta previa (225, 44.7%), placental abruption (21, 4.2%), preeclampsia with severe feature(s) (133, 26.4%) and gestational hypertension (3, 0.6%). The average Apgar score (1 min, 5 min) were (9.7±0.5, 10.0±0.0) in the group of parturients with central nervous diseases, (9.7±1.0, 10.0±0.3) in that of hematological diseases, (8.5±2.4, 9.2±1.8) in that with obstetric related indications, (9.7±0.8, 10.0±0.2) with immunological diseases, and (8.7±2.4, 9.3±1.8) in unknown group.
Cesarean rate remained high in our institution. There was a surge of general anesthesia utilization, resulting from the increased number of parturients with comorbidities. While the outcome from general anesthesia for cesarean delivery was acceptable, general acceptance of neuraxial anesthesia was still low. The general system parturient care model and workflow could also play a role.
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