Anaesthesia for caesarean deliveries and maternal complications in a Nigerian teaching hospital.

Abstract

Background: The aim of this audit was to evaluate the frequency of caesarean delivery, anesthetic techniques employed, investigate potential trends and the rate of maternal complications associated with general or regional anesthesia in our institution. Methods: We reviewed data collected on all deliveries from patients' medical records, anesthetic charts and relevant surgical notes from 1 January 2008 to 3 1 December 2010. Results: A total of 10,911 deliveries were conducted during the study period and there were 3389 caesarean sections, giving a rate of 31.1%; which showed an upward trend from 27.8% in the first year to 34% in the third year. Our data showed a predominant use of regional anesthesia for caesarean section generally (86.2%) and 83.8% for emergency caesarean deliveries in line with global trends. The overall complication rate was 10.5%. However, 34.5% of parturient who had general anesthesia in contrast with 6.7% who had regional techniques had anesthesia-related complications, postoperative intensive care unit admission rather than recovery room care, intra-operative cardiac arrest and hemorrhage exceeding 1200ml (p = 0.001). Hemodynamic fluctuations were the most common anesthesia-related complication. Our data revealed that general anesthesia was a significant risk factor for maternal complications. Conclusion: Obstetric general anesthesia is low in our hospital. Our result showed that general anesthesia was a significant risk factor for maternal complications during caesarian section