Анестезия и клинические исследования
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Evaluation of the Role of Induced Uterine Contraction on Blood Loss during Caesarean Section under Different Types of Anesthesia: A Double Blind Controlled Study

Ahmed Said Elgebaly, Rabab Mohamed Mohamed Mohamed

Background: Delivery by Caesarean section (CS) can cause more complications than normal vaginal delivery and one of its common complications is postpartum bleeding which can be life threatening. To reduce maternal mortality and morbidity caused by bleeding, it is important to reduce the extent of bleeding during and after CS.

Objectives: To compare between the efficacy of using prostaglandin F2α under spinal or general anesthesia on decreasing the amount of blood loss during elective caesarean section.

Settings and design: A prospective, double blind controlled randomized and comparative study.

Methods: 60 patients undergoing elective lower segment caesarean section were divided into two groups: Group A received general anesthesia with subtypes A1 (general anesthesia=control group), and A2 (general anesthesia +prostaglandin F2α) and Group B received spinal anesthesia with subtypes B1 (spinal anesthesia=control group), and B2 (spinal anesthesia+prostaglandin F2α), hemodynamics, total blood loss , Hemoglobin Hb (gm/dl) and hematocrit Hct (%) values were recorded before and after the operation.

Results: There was significant difference in total blood loss (ml) between general and spinal anesthesia groups which was 772.333 ± 144.287 in group A and 623.667 ± 119.779 in group B and significant increase in total blood loss in group A1 when compared with other three groups, significant increase in group A2 when compared with B2, insignificant changes between A2 and B1 and significant increase in total blood loss in group B1 when compared with group B2. Also the same manner present in MAP and HR where there was significant difference in MAP and HR in group A1 when compared with other three groups, significant difference in group A2 when compared with B2, insignificant changes between A2 and B1 and significant difference in MAP and HR in group B1 when compared with group B2 at 10 and 20 min but there was insignificant changes at preoperative and immediately postoperative measurements between 4 subgroups.

Conclusion: PGF2α under spinal anesthesia decreases the amount of blood loss during cesarean section.