Anesthetic complications in cesarean section

Vijaya P. Borkar Patil, Jayshree J. Upadhye


Background: Obstetric anesthetists need to face with the unique situation of providing anesthesia for caesarean sections, where they have to provide care for both the mother and the unborn baby. This study was performed in 100 women who underwent cesarean section, either elective or emergency to evaluate type of anesthesia, anesthetic complications and neonatal outcome.

Methods: A retrospective study was conducted in 100 women with singleton pregnancy undergoing cesarean section in the department of Anesthesiology in collaboration with department of Obstetrics and gynecology at Dr PDMMC and Hospital, Amravati from January 2017 to March 2018. Detailed information regarding medical and obstetric history, intrapartum course, postpartum complications diagnosed before hospital discharge, and infant outcome were collected directly from maternal and infant charts. Other details like age of the patient, parity, type of cesarean section and type of anesthesia was noted. American Society of Anesthesiologists (ASA) scores and type of anesthesia was noted.

Results: In our study, spinal anesthesia was given in 62 (62%) patients, epidural anesthesia was given in 20 (20%) patients, combined spinal-epidural anesthesia was given in 10 (10%) patients while general anesthesia was given in 8 (8%) patients. Anesthetic complications were less. About 10 (10%) patients had spinal headache, 4 (4%) patients had failed regional anesthesia, 2 (2%) patients had failed intubation while 2 (2%) patients had high spinal anesthesia. Babies of 96 (96%) patients had Apgar score at 5 minutes of more than 7 and babies of 4 (4%) patients had Apgar score at 5 minutes of less than 7. Only babies of 2 (2%) patients required intubation for resuscitation.

Conclusions: This study provides strong evidence that the guidelines recommending regional block over GA for most cesarean section. It is beneficial for neonates as well as for mothers.


Caesarean section, Obstetrics, Regional anesthesia

Full Text:



Sia ATH, Fun WL, Tan TU. The ongoing challenges of regional and general anesthesia. Best Prac Res Clin Obstetrics Gyn. 2009;24:303-12.

American Society of Anesthesiologists Task Force on Obstetric Anesthesia: Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. 2007;106:843-63.

Bloom SL, Spong CY, Weiner SJ, Landon MB, Rouse DJ, Varner MW, et al. Complications of anesthesia for cesarean delivery. Obstet Gynecol. 2005;106:281-7.

Barash PG, Cullen BF, Stoelting RK. Clinical anesthesia. 4th ed. Philadelphia (PA): Lippincott Williams and Wilkins;2001:474.

Reynolds F, Seed PT: Anaesthesia for Caesarean section and neonatal acid-base status: a meta-analysis. Anesthesia. 2005;60:636-53.

Banks A, Levy D. General Anesthesia for operative obstetrics. Anesthesia Intensive Care Med. 2007;8:317-9.

Manner UB, de Boisblanc, MS Suresh. Airway problems in pregnancy. Crit Care Med. 2005;33:259-68.

McGlennan A, A Mustafa. General Anesthesia for Caesarean Section. CEPD reviews. 2009;9:148-51.

Brain AIJ, C Verghese, Strube PJ. The LMA Proseal-a laryngeal mask with an esophageal vent. British J Anesthesia. 2000;84:650-54.

Sean Brian Yeoh, Sng Ban Leong, Alex Sia Tiong Heng, Anaesthesia for lower-segment caesarean section: Changing perspectives, Indian J Anaesth. 2010 Sep-Oct;54(5):409-14.

Patil P, Bhardwaj M, Sharma P, Chandrakar G. Changing trends in indication of cesarean section in a tertiary care centre of Central India. Int J Reprod Contracept Obstet Gynecol. 2017;6:2829-35.

Gupta M, Garg V. The rate and indications of caesarean section in a teaching hospital at Jaipur, India. Int J Reprod Contracept Obstet Gynecol. 2017;6:1786-92.

Begum T. Indications and determinants of caesarean section delivery: Evidence from a population-based study in Matlab, Bangladesh. PLoS One. 2017;12(11):e0188074

Bloom SL, Spong CY, Weiner SJ, Landon MB, Rouse DJ, Varner MW, et al. Complications of anesthesia for cesarean delivery. Obstetrics & Gynecology. 2005 Aug 1;106(2):281-7.

Hawkins JL, Chang J, Palmer SK, Gibbs CP, Callaghan WM. Anesthesia-related maternal mortality in the United States: 1979-2002. Obstetrics Gynecology. 2011;117(1):69-74.

Deneux-Tharaux C, Carmona E, Bouvier-Colle MH, Bréart G. Postpartum maternal mortality and cesarean delivery. Obstetrics & Gynecology. 2006 Sep 1;108(3):541-8.

Huang CH, Hsieh YJ, Wei KH, Sun WZ, Tsao SL. A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: a retrospective cohort study. Acta Anaesthesiologica Taiwanica. 2015 Mar 1;53(1):7-11.