Анестезия и клинические исследования
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Birth Outcome after Caesarean Section among Mothers who Delivered by Caesarean Section under General and Spinal Anesthesia at Gondar University Teaching Hospital North-West Ethiopia

Zewditu Abdissa, Tadesse Awoke, Tadesse Belayneh and Yifokir Tefera

Introduction: Intrapartum death is the leading cause of child mortality in the world. In Africa, 62 new borns die out of 1000 live births. Anesthesia is responsible for 89 intrapartum deaths per 1000 live births and 3-12% maternal deaths; which are almost associated with the use of general anesthesia. The objective of this study was to assess neonatal outcomes using APGAR score among mothers delivered by caesarean section at Gondar University Hospital, North west Ethiopia.

Methods: An institution based cross sectional study was used to assess neonatal outcomes after caesarean sectionamong mothers delivered by caesarean section under anesthesia. All mothers that came for caesarean section from January1, to April 30, 2012 were included in this study Data were collected using structured questionnaires. All pre delivery questionnaires were filled during pre operative preparation after taking informed consent and other intra operative events were recorded intra operatively in the operation room. Data entry and analysis was done using SPSS version 16, each variable was entered to bivariate analysis, variables with P value <0.2 were taken to multivariate analysis using logistic regression.

Results: The use of general anesthesia for caesarean section in this particular study was more frequent when compared with spinal anesthesia (65%). The risk of Low APGAR score 5 was increased in babies born under general anesthesia as compared with babies born under Spinal anesthesia (AOR=3.19,95% C.I.(1.73, 5.90)). Low Fetal weight was associated with low APGAR score of new borns (AOR=1.38 with 95% C.I. (1.10, 1.70)). Pre anesthetic fetal heart rate and uterine incision to delivery time were also found to be associated with APGAR score 5 of neonates (AOR=2.12, (95% CI, 1.20; 3.60) and 2.57, (95% CI, 1.20, 3.50)) respectively.

Conclusion: Neonates born under Spinal anesthesia had better physiologic profile as evidenced by APGAR score 5. The use of general anesthesia should be reduced and reserved for special indications that are contra indicated to spinal anesthesia only. Low birth weight, prolonged uterine incision to delivery of the baby and pre anesthetic fetal heart beat has affected APGAR score 5 of newborns.