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Scholars Journal of Applied Medical Sciences | Volume-10 | Issue-10
The Efficacy of the Spinal Anesthesia during Emergency Cesarean Section for Severe Preeclampsia and Eclampsia Patients
Dr. M M Nasimuzzaman, Dr. Md Aminur Rahman, Dr. Jahid Hasan, Md. Injamul Huq, Dr. Sharmina Rahman Chowdhury, Oasis Mohammod
Published: Oct. 12, 2022 | 187 200
DOI: 10.36347/sjams.2022.v10i10.017
Pages: 1690-1694
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Abstract
Background: In Bangladesh, severe preeclamptic toxemia and eclampsia are life-threatening conditions in pregnancy that are the leading cause of perinatal maternal and neonatal mortality and morbidity. Objective: in this study our main aim is to evaluate the efficacy of the Spinal Anesthesia during Emergency Cesarean Section for Severe Preeclampsia and Eclampsia Patients. Method: This cross sectional study was carried out at tertiary medical hospital from January 2021 to January 2022. Total 200 cases of severe PET (n=110) and eclampsia (n=100) patients were selected by subarachnoid block for emergency LUCS. Each patient was given magsulph as prophylactic or maintenance dose and judiciously preloaded by crystalloid fluid. Results: Most of the patients belong to 31-40 years age group, 52% and 95.8% cases were multigravida. In severe PET group, intraoperative hypotension was observed in 32% cases and postoperative period hypotension was observed in 8% cases. Whereas preeclampsia group, intraoperative hypotension was observed in 31% cases and postoperative period hypotension was observed in 9% cases. In addition,maternal morbidity where acute renal failure seen in 5%, syndrome 7%, DIC 7%, abruptio placentae 12%, pulmonary edema 4%, septicemia 13%, PPH 10% and postpartum eclampsia 15%.In severe PET group, 21% cases transferred to eclampsia ward, followed by 9% shifted to ICU, 1% case was expired. Whereas, in preeclampsia group 20% cases transferred to eclampsia ward, followed by 8% shifted to ICU, 2% case was expired. In eclamptic group 7% cases were transferred to NCU, whereas 8% had PET. Neonatal mortality was observed in 3% cases. p value was found 0.000 which is very highly significant. Conclusion: With close monitoring of perioperative events, spinal anesthesia may be used as a safe alternative technique to GA or epidural in severe preeclampsia and eclampsia, even in cases of altered consciousness or restlessness in the presence of an expert and skilled .............