THE RISK OF POST PARTUM HEMORRHAGE AFTER CESAREAN SECTION WITH GENERAL VERSUS SPINAL/EPIDURAL ANAESTHESIA

Abstract

Background: In this study, we set out to compare the risk of PPH after CS for those who receive general versus spinal/epidural anesthesia with the use of a one-year dataset, we hypothesized that women who received general anesthesia would be at higher risk of PPH compared with women who received epidural anesthesia because adverse uterine contraction and platelet function might be associated with general anesthesia.. Objectives: To assess frequency of postpartum hemorrhage in general anaesthesia, to assess frequency of postpartum hemorrhage in spinal anaesthesia, to compare the risk of Postpartum Hemorrhage (PPH) for patients who will undergo CS with general versus spinal/epidural anesthesia and to assess risk of type of anaesthesia in developing PPH. Patients and methods: This is a retrospective study on patients complicted by PPH after CS with history of type of anaesthesia used; general or spinal/epidural anaesthesia to detect the risk of developing PPH. We included all women complicated by PPH after CS and collect data about the anaesthesia used during CS and other risk factors for PPH if recorded in files of operative sheet of the patients. Hemoglobin concentration before surgery and on first postoperative day was recorded for all patients. The total volume of crystalloid solutions infused during operation and duration of operation were determined. Results: Our results showed that 42.3% of the studied group had general anaesthesia and 57.7% of them had spinal anaesthesia. There was statistical significant difference between patients who received general anesthesia and patients who received spinal anaesthesia in number of cases having postpartum hemorrhage.. Conclusion: The odds that women will experience caesarean PPH with general anaesthesia are approximately 3.5times higher than for women who undergo CS with spinal anesthesia.
Key Words: postpartum hemorrhage, cesarean section, general anesthesia, spinal anesthesia, epidural anesthesia.