Anesthesia for Cesarean Section and Postpartum Cardiovascular Events in Congenital Heart Disease: A Retrospective Cohort Study
| Autor: | Eiki Kanemaru, Jun Yoshimatsu, Chizuko Kamiya, Michikazu Nakai, Soshiro Ogata, Kenji Yoshitani, Yoshihiko Ohnishi, Rie Tsukinaga, Yosuke Kubota, Akito Tsukinaga, Kunihiro Nishimura |
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| Rok vydání: | 2020 |
| Předmět: |
Heart Defects
Congenital Heart disease medicine.medical_treatment 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Pregnancy Medicine Intubation Anesthesia Obstetrical Humans reproductive and urinary physiology Retrospective Studies business.industry Cesarean Section Postpartum Period Infant Newborn Retrospective cohort study medicine.disease Pulmonary hypertension Anesthesiology and Pain Medicine Heart failure Anesthesia Anesthetic Apgar score Female Cardiology and Cardiovascular Medicine business Cohort study medicine.drug |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 35(7) |
| ISSN: | 1532-8422 |
| Popis: | To clarify the association between anesthetic technique and maternal and neonatal outcomes in parturients with congenital heart disease (CHD).Retrospective, observational cohort study.An academic hospital.A total of 263 consecutive parturients with CHD who underwent cesarean section from 1994 to 2019.None.The authors compared postpartum cardiovascular events (composite of heart failure, pulmonary hypertension, arrhythmia, and thromboembolic complications) and neonatal outcomes (intubation and Apgar score7 at one or five minutes) by anesthetic technique. Among 263 cesarean sections, general anesthesia was performed in 47 (17.9%) parturients and neuraxial anesthesia in 214 (81.3%) parturients. Cardiovascular events were more common in the general anesthesia group (n = 7; 14.9%) than in the neuraxial anesthesia group (n = 17; 7.9%). Generalized linear mixed models assuming a binomial distribution (ie, mixed-effects logistic regression), with a random intercept for each modified World Health Organization classification for maternal cardiovascular risk, revealed that general anesthesia was not significantly associated with cardiovascular events (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.30-3.29). In addition, general anesthesia was associated with composite neonatal outcomes (Apgar score7 at one or five minutes or need for neonatal intubation; OR, 13.3; 95% CI, 5.52-32.0).Anesthetic technique is not significantly associated with postpartum composite cardiovascular events. General anesthesia is significantly associated with increased need for neonatal intubation and lower Apgar scores. |
| Databáze: | OpenAIRE |
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