Comparison of feto-maternal outcome of general And spinal anesthesia among pregnant mothers who Underwent category one caeserean sections –a Prospective cross-sectional study at jimma University medical center, jimma, ethiopia 2022.

Abstract

Background: Category one cesarean section is performed in the most urgent conditions for the fetus or mother and sometimes in both cases. Now-a days, the practice of anesthesia for emergency cesarean sections is becoming spinal over general anesthesia due to adverse feto- maternal outcome. Objectives: To compare feto-maternal outcomes of general and spinal anesthesia during category one cesarean deliveries at Jimma University Medical Center, 2022. Methods: A prospective comparative cross-sectional study was conducted at Jimma University Medical Center from August to October, 2022. The study included 72 cases of category one caesarean sections during the study period. Indications for category one cesarean delivery, DDI, maternal vital signs, intraoperative blood loss and need for blood transfusion and ICU admissions were noted to compare maternal outcomes. On the other hand, for comparison of newborn outcomes, variables such as APGAR scores at one and five minutes, need for bag mask ventilation, intubation and NICU admissions were used. Independent sample student’s t-test was used for comparison of normally distributed continuous data and Mann Whitney U test for non-normally distributed data. Chi-square and Fisher Exact tests were used for comparison of categorical data. P-value less than 0.05 was used to show statistically significant difference on outcomes between groups. Result: The ages of the participants were comparable between general and spinal anesthesia, in which the mean was 27.86± 5.42 and 26.27± 6.77 years, respectively; p= 0.344. Baseline maternal vital signs were also not significantly different statistically between groups. DDI and one and five minute Apgar scores were significantly different between groups. There also was statistically significant difference between groups regarding blood loss and requirement for transfusion of blood products. There was no significant difference between general and spinal anesthesia regarding neonatal and maternal death statistically. Conclusion: General anesthesia may be considered faster than spinal anesthesia during emergency caeserean section deliveries, but associated with fetal and maternal morbidity compared to spinal anesthesia. Spinal anesthesia might be better over general anesthesia to have a favorable outcome if and only if there are no contraindications