Department of Anesthesia, Shaare Zedek Medical Center, Jerusalem, Israel.
Medical School, Hebrew University of Jerusalem, Israel.
Taiwan J Obstet Gynecol. 2021 Jan;60(1):70-77. doi: 10.1016/j.tjog.2020.11.010.
Inflammatory bowel diseases (IBD) are a group of pathologies associated with an increased rate of abortions, premature deliveries, cesarean sections and other morbidity during the peripartum period. The objective of this retrospective study was to investigate the anesthetic management for delivery of women with IBD.
The records of patients with IBD, who delivered at our Center, were obtained for data which included anesthetic and obstetric management as well as neonatal outcome. Five subgroups were defined based on mode of delivery, presence or absence of epidural in normal vaginal delivery (NVD) and urgency of cesarean section, each of which was compared with control groups of healthy parturients in the same period. Additionally, the rate of cesarean sections and the use of epidural analgesia for NVD were compared with the general obstetric population of our center in the same period.
107 patients with IBD who delivered at our center were studied. The rates of cesarean sections and emergency cesarean sections were significantly higher compared to the general population. However, the rate of instrumental delivery and of epidural analgesia use for NVD were similar. Among those who underwent cesarean sections, no significant differences were found in anesthesia type, surgery duration, number of complications, type of monitoring or postoperative management compared to the control group.
Peripartum anesthetic management of patients with IBD does not differ significantly from that of parturients without it. Anesthesiologists can plan their anesthesia in a similar way as they do in healthy parturients.
炎症性肠病(IBD)是一组与围产期流产、早产、剖宫产和其他发病率增加相关的疾病。本回顾性研究的目的是探讨 IBD 患者分娩的麻醉管理。
我们中心收治的 IBD 患者的病历被获取,以获得包括麻醉和产科管理以及新生儿结局的数据。根据分娩方式、正常阴道分娩(NVD)中是否使用硬膜外麻醉以及剖宫产的紧急程度将患者分为 5 个亚组,每个亚组均与同期健康产妇的对照组进行比较。此外,还比较了同期我院普通产科人群的剖宫产率和 NVD 硬膜外镇痛使用率。
研究了在我们中心分娩的 107 例 IBD 患者。剖宫产率和紧急剖宫产率明显高于普通人群。然而,器械分娩率和 NVD 硬膜外镇痛使用率与普通人群相似。在接受剖宫产的患者中,与对照组相比,麻醉类型、手术持续时间、并发症数量、监测类型或术后管理无显著差异。
IBD 患者围产期的麻醉管理与无 IBD 患者无显著差异。麻醉师可以以与健康产妇相同的方式计划他们的麻醉。