Comparison of General and Spinal Anesthesia on Maternal Hemoglobin Changes after Caesarean Section
Batool Teimoori1, Marzie Ghasemi1 , Alireza Jahangirifard2 , Maziar Mahjoubifard3*, Hassan Enayati3, and Tahere Ostadmahmoodi31Department of Obstetrics and Gynecology, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
2Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3Zahedan University of Medical Sciences, Zahedan, Iran.
Corresponding Author Email: m_mahgobifard@yahoo.com
Abstract: WHO estimates 585,000 maternal deaths per year among which 25% is directed by partum hemorrhage. The average volume of bleeding is supposed to be around 500 ml in natural vaginal childbirth while 1000 ml through caesarean section. Regarding much more recent demands for caesarean section, there have been obvious attempts to get effective harm reduction of this surgery by decreased bleeding through several strategies such as selecting more perfect and ideal techniques of anesthesia. Through a randomized controlled trial in 2013, all the elective CS referrals to a university hospital in Zahedan with 38-40 weeks gestational age enrolled via easy sampling before being divided into two groups of general and spinal anesthesia. Patients' hemoglobin and HCT in addition to blood pressure were the major factors which were checked and compared between the groups. HB fell significantly more in patents with general anesthesia, especially at the range of 1-2 g/dl after 6 and 24 hours of CS. Around 91% of GA and more than 50% of SA had middle changes in HB and HCT. These changes were significantly different between GA and SA. The two groups were simply similar according to greater changes including 2-3 g/dl in HB or 6-9 in HCT and contain a minor part of the patients. The present study indicated that bleeding and decreased HB and HCT occur significantly less in spinal anesthesia comparing to general anesthesia. It would need more trials to assess the role of personal conditions in patients and surgeons as well as newer techniques and medications dynamically as well.
Keywords: Caesarean Section; General Anesthesia; Spinal Anesthesia; Hemoglobin; Hematocrit Back to TOC