Maternal and fetal outcomes following unplanned conversion to general anesthetic at elective cesarean section

• Published in: Journal of perinatology 2015-09, Vol.35 (9), p.695-699
• Main Authors: Aiken, C E, Aiken, A R, Cole, J C, Brockelsby, J C, Bamber, J H
• Format: Article
• Language: English
• Subjects: 692/308/409; Adult; Anesthesia; Anesthesia, General - methods; Anesthesia, General - statistics & numerical data; Blood Loss, Surgical - statistics & numerical data; Cesarean section; Cesarean Section - adverse effects; Cesarean Section - methods; Cesarean Section - statistics & numerical data; Confidence intervals; Conversion; Dosage and administration; Elective Surgical Procedures - adverse effects; Elective Surgical Procedures - methods; Elective Surgical Procedures - statistics & numerical data; Female; Fetus; Fetuses; General anesthetics; Health aspects; Health risk assessment; Hemorrhage; Humans; Incidence; Infant, Newborn; Maternal Age; Medicine; Medicine & Public Health; Neonates; Obstetric Labor Complications - epidemiology; original-article; Parity; Patient Care Planning - statistics & numerical data; Patient outcomes; Pediatric Surgery; Pediatrics; Pregnancy; Pregnancy Outcome; Pregnant women; Risk analysis; Risk factors; Statistical analysis; United Kingdom - epidemiology
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2015.62

Objective: To investigate risk factors predicting unplanned conversion to general anesthesia during elective cesarean section, and to examine maternal and fetal outcomes associated with unplanned conversion compared with other modes of anesthesia. Study Design: A retrospective cohort at a UK center (2008 to 2013). Women (4337) underwent elective cesarean section. Delivery outcomes were compared according to anesthesia type using logistic regression. Result: Women (1.6%) underwent unplanned conversion to general anesthetic. Unplanned conversion was associated with higher parity (odds ratio (OR) 3.82, confidence interval (CI; (1.58 to 9.62)) and maternal age ⩾40 (OR 4.40, CI (1.08 to 29.88)). Compared with spinal anesthetic, unplanned conversion was associated with increased likelihood of maternal hemorrhage ⩾1.5 l (OR 5.74, CI (1.90 to 14.01)) and delayed neonatal respiration (OR 4.76, CI (1.76 to 11.05)). Adverse outcomes were not significantly more likely compared with planned general anesthetic. Conclusion: Higher parity and maternal age are risk factors for unplanned conversion to general anesthetic. There is no increase in the likelihood of adverse outcomes with unplanned versus planned general anesthetic.