Impact of spinal anesthesia on cesarean section outcome in Omdurman maternity hospital - Sudan 2011

Abstract

Background: The cesarean section is indicated when vaginal delivery is not safe for the mother or the baby.
Objective: A descriptive study done in Omdurman maternity hospital–OMH to assess the impact of spinal anesthesia (SA) on cesarean section(C/S), including, intra and post operative maternal complications, neonatal outcome and patients’ satisfaction in 2011.
Methodology: Women delivered by C/S under SA were included in the study after an informed consent. All women in the study were operated on by trained registrars or obstetricians, under SA given, either by anesthetist or assistant anesthetist under supervision with similar conditions and
were followed till discharge from hospital.
Results: Total number of deliveries at OMH in 2011 were 30397, 21677 (71.3%) delivered vaginally, 8720 (28.7%) delivered by C/S, only 24 women (0.3%) delivered under general anaethesia- GA. Women included in the study were 1029, 517 (50.2%) were elective and 512 (49.8%) were emergency C/S. Intra- operatively, 79 women (7.7%) developed hypotension, their BP dropped by more than 30 mmHg, four women developed severe shivering for which they received intravenous 25 mg pethedine, and 44 neonates received oxygen by mask and only one
needed endotranchial intubation. Post operatively, only two women had disabling headache, 24 women (2.4%) had episodes of vomiting and 199 (19.3%) had pain in their lower limbs, buttock and thigh, it disappeared completely before discharge. In this study, 880 women (85.5%) were
satisfied with SA, while 149 (14.5%) were not satisfied due to pain at the time of puncture, headache, or transient lower limb pain after operation.
Conclusion:Spinal anesthesia is increasingly used for C/S in this hospital, with excellent patients’ satisfaction, without increase in maternal and neonatal mortality or morbidity.

Key words: spinal anesthesia, Cesarean section, Sudan