Effect Of Anaesthesia On Morbidity And Mortality In Emergency Caesarean Section Patients In Calabar, Nigeria

Abstract

The outcome of obstetric anaesthesia following emergency Caesarean sections was studied retrospectively. The study which was carried out in the University of Calabar Teaching Hospital covered the period between 1st August 1995 – 31st August 2000. The aim was to evaluate the morbidity and mortality from anaesthesia during the period under review. Out of 1533 Caesarean sections performed 920 were emergency giving an emergency Caesearean section rate of 60%. The main indications for the emergency Caesearean sections were obstructed labour 220 (23.9%), foetal distress 193 (19.9%) and pre-eclampsia/eclampsia 142 (15.4%). General anaesthesia was employed in 555 (60.3%) while spinal was used in 365 (39.7%). Morbidity recorded in the spinal anaesthesia group were severe hypotension 110(30%), post dural puncture headache (PDPH) 46(2.6%) and transient neurologic symptoms (TNSs) 1 (0.022%). No mortality was recorded in the spinal anaesthesia group. Morbidity in the general anaesthesia group was mainly sore throat 364(65.6%) Five deaths were recorded in the general anaesthesia group. Four deaths occurred probably due to hypoxia following failed intubation, while the fifth death followed an unsuccessful cardiopulmonary resuscitation in an eclamptic patient, or due to eclampsia. From this study, mortality was recorded in the general anaesthesia group. Spinal anaesthesia, when there is no contra- indication is therefore recommended for safe obstetric anaesthesia. Brisk pre-operative evaluation, optimization of pre-operative clinical status of parturients and competent anaesthetist are of paramount importance.

Key words: Obstetric anaesthesia; emergency caesarean section; morbidity and mortality.

Nigerian Journal of Physiological Sciences Vol.18(1-2) 2003: 77-81