The Effect Of Anesthetic Technique On Fetal Outcome Among Mothers Undergoing Caesarean Section For Non-reassuring Fetal Status At Addis Ababa Public Hospitals Addis Ababa Ethiopia

Background: Emergency Cesarean Sections are performed for various reasons. One of thernreasons to do Cesarean Section (CS) is non-reassuring fetal status. Cases with emergency rncaesarean sections like non-reassuring fetal status are challenging for the obstetric anesthetist andrnobstetrician because such cases are highly associated with life-threatening complications for thernfetus and/or the mother. So, choosing appropriate anesthetic technique in such cases is essentialrnin decreasing fetal and maternal morbidity and mortality. rnObjective: To assess the effects of anesthetic technique, General Anesthesia (GA) versus SpinalrnAnesthesia (SA), over neonatal outcome of newborns delivered by CS for the indication of nonreassuringrnfetalrnstatusrninrnAddisrnAbabarngovernmentrnhospitals,rninrn2019/2020rnrnrnMethods:rnArnprospectiverncohortrnstudyrnwasrnconductedrnonrn200rnpregnantrnmothersrnwhorncamernforrnCSrnrnforrnrnthe indication of non-reassuring fetal status and fulfill the inclusion criteria for the study.rnPatients in SA group (n = 100) received spinal anesthesia with 10 mg of bupivacaine while the rnGA group (n = 100) received general anesthesia. Study participants were selected by systematicrnrandom sampling technique after proportional allocation to the study hospitals. Data wererncollected using preoperative chart review, maternal interview and intraoperative observation.rnComparisons of numerical variables between study groups were done using independent samplernt-test and categorical variables were performed using chi-square test. Significance wasrndetermined at p-value < 0.05.rnResults: There was a significant difference in the mean of 1 minute Apgar score between SA andrnGA groups among newborns delivered by caesarean section for the indication of non-reassuringrnfetal heart status (Mean = 7.28, SD = 1.16) and (M = 6.64, SD = 1.44; p = 0.001) for SA and GArnrespectively. But there was no significant difference in 5 minute Apgar score. There was nornsignificant difference in neonatal intensive care unit admission between GA and SA groups, χ2rn(1) = 0.31, p =0.57.rnConclusions: this study revealed that newborns delivered under SA had better 1 minute meanrnApgar score when compared with GA. Based on this we recommend SA for mothers with therndiagnosis of non-reassuring fetal status.

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