5. Evaluation of Obstetric Anaesthesia and its Association with Maternal Outcomes in Women with Placenta Previa: A Cross-Sectional Study
Shandana Bawar, Qudsia Qazi and Syeda Sitwat Fatima
ABSTRACT
Objective: To determine the frequency of mode of anaesthesia (MOA).The secondary outcome was to determine an association between MOA, type 4 PP, previous CS and maternal outcomes.
Study Design: A retrospective cross-sectional study.
Place and Duration of Study: This study was conducted at the Department of Obstetrics and Gynecology (OBGYN), MTI Lady Reading Hospital Peshawar from January 2020 - December 2022.
Methods: It included women with singleton pregnancy with PP, after 28 weeks of gestation. Women with other causes of antepartum haemorrhage, previous myomectomy and medical disorders complicating pregnancy were excluded. Maternal outcomes included per-operative blood loss (POBL), per-operative RBC transfusion(POBT) and transfer to the critical care unit(TCCU) as mentioned in operative notes. Data was collected and analyzed by SPSS version 22.
Results: A total of 170 women were included in two years. MOA included General anaesthesia (GA) in 96(56.5%) and Spinal anaesthesia (SA) in 74(43.5%) cases.GA was frequently given in Emergency CS (EMCS), elective CS(ELCS) and type 4 PP.POBL of less than 1500ml dominated, POBT of less than or equal to 4 pints was found to be 143(84.1%) while a large number of patients were managed in obstetrical wards 150(88.2%) compared to HDU and ICU with a non-significant association.
Conclusion: GA was frequently adopted in our setup compared to SA, especially with the increasing severity of PP type and previous CS. Both GA and SA were safe with non-significant association with blood loss, RBC transfusion and critical care management.
Key Words: Placenta Previa, Mode of anaesthesia, per operative blood loss, Per operative blood transfusion, Critical care transfer