Fetal and Maternal Outcomes Following Cesarean Hysterectomy: A Comparison of General vs. Regional Anesthesia [6L]

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Little information is available on the preferred route of anesthesia for cesarean hysterectomy.


Retrospective chart review from 2005–2015 at a single community-based teaching institution.


Significant differences were seen in APGAR scores, NICU length of stay, EBL, and total operating time. Mean gestational age for patients delivered under general anesthesia was 13 days less than patients delivered under regional. No differences were seen in arterial and venous cord pH values. One maternal death occurred in the regional anesthesia group. Two neonatal deaths occurred, and in both instances, only comfort care was provided.


Significant differences in neonatal APGAR scores under general anesthesia were anticipated due to in-utero anesthetic exposure. A longer NICU length of stay was seen in neonates born under general anesthesia, however, the mean gestational age at delivery may explain this difference. EBL was higher in the regional anesthesia group, and may correlate with the longer operating time. While there was a difference observed in neonatal APGAR scores when cesarean hysterectomy is performed under general anesthesia, we conclude that these are clinically insignificant, and any increased NICU length of stay may be related to earlier gestational age at delivery rather than the type of anesthesia. Based on the short-term outcomes in this study, we conclude that general anesthesia is safe for neonates born via cesarean hysterectomy. Total operating time and EBL were higher in the regional anesthesia group, and general anesthesia may be preferred from a maternal standpoint.

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