Anaesthesia for caesarean deliveries and maternal complications in a Nigerian teaching hospital.

BACKGROUND

The aim of this audit was to evaluate the frequency of caesarean delivery, anaesthetic techniques employed, investigate potential trends and the rate of maternal complications associated with general or regional anaesthesia in our institution.

METHODS

We reviewed data collected on all deliveries from patients' medical records, anaesthetic charts and relevant surgical notes from 1 January 2008 to 31 December 2010.

RESULTS

A total of 10,911 deliveries were conducted during the study period and there were 3389 caesarean sections, giving a rate of 31.1%; which showed an upward trend from 27.8% in the first year to 34% in the third year. Our data showed a predominant use of regional anaesthesia for caesarean section generally (86.2%) and 83.8% for emergency caesarean deliveries in line with global trends. The overall complication rate was 10.5%. However, 34.5% of parturients who had general anaesthesia in contrast with 6.7% who had regional techniques had anaesthesia-related complications, postoperative intensive care unit admission rather than recovery room care, intra-operative cardiac arrest and haemorrhage exceeding 1200 ml (p = 0.001). Haemodynamic fluctuations were the most common anaesthesia-related complication. Our data revealed that general anaesthesia was a significant risk factor for maternal complications.

CONCLUSION

Obstetric general anaesthesia is low in our hospital. Our result showed that general anaesthesia was a significant risk factor for maternal complications during caesarean section.