The Impact of the COVID-19 Pandemic on Anesthesia Management and Clinical Outcomes in Cesarean Section Surgery

Year 2023, , 359 - 365, 31.08.2023

İlsev Babaoğlan , Demet Laflı Tunay , Murat Türkeün Ilgınel , Nazlı Totik Doğan

https://doi.org/10.36516/jocass.1342597

Abstract

Giriş: Cerrahi hastalarda bilinen COVID-19 enfeksiyonu olmasa dahi pandemi sürecinde postoperatif morbidite ve mortalitenin artığı bilinmektedir. Bu çalışma ile, 2019 Eylül - 2020 Eylül tarihleri arasında sezaryen (C/S) ameliyatına alınan gebeler, pandemi öncesi ve sonrası olmak üzere iki ayrı grupta ele alınarak pandemi döneminin anestezi tercihi ile anne ve bebekle ilgili sonuçlar üzerine etkileri değerlendirilmek istenmiştir.
Gereç ve Yöntemler: Bu çalışmada üçüncü basamak bir hastanede bir yıllık deneyim kapsamında sezaryen ameliyatına alınan gebeler, COVID-19 pandemisi öncesi ve sonrası olmak üzere iki ayrı dönemde retrospektif olarak incelendi. Çalışmanın birincil sonuç ölçütü, pandemi döneminde C/S operasyonlarındaki rejyonel anestezi uygulanma oranları idi.
Bulgular: 1241 C/S olgusunun analiz edildiği bu çalışmanın sonuçlarına göre, anne yaşı, gebelik haftası, gravida, gebelikle ilgili morbiditeler, APGAR skoru dahil yenidoğana ait veriler ve C/S cerrahisi endikasyonları erken COVID-19 pandemisi döneminde değişikliğe uğramamıştır. Ancak anneye ait anemi dahil ek hastalık oranı, yenidoğan yoğun bakıma yatış oranı ve hastanede kalış süresi pandemic döneminde öncesine göre azalmış; rejyonel anestezi uygulamaları ve postoperatif maternal komplikasyon oranları ise artmıştır.
Sonuç: Bu çalışmada, obstetrik anesteziye dair gerek klinik uygulamalarda gerekse hasta sonuçlarında COVID-19 pandemisi dönemi ile birlikte çeşitli değişikliklerin ortaya çıktığı gözlenmiştir.
Anahtar Kelimeler: Sezaryen, COVID-19, obstetrik anestezi, pandemi.

Keywords

Cesarean section, COVID-19, obstetric anesthesia, pandemic.

References

• 1.https://covid19.who.int Date of Access: 20.07.2023
• 2.Royal College of Obstetricians & Gynaecologists. Coronavirus (COVID-19) infection in pregnancy. Information for healthcare professionals. Version. 2022 Dec 9;16.
• 3.Afolabi BB, Lesi FE, Merah NA. Regional versus general anaesthesia for cae¬sarean section. Cochrane Database Syst Rev. 2006;(4):CD004350. https://doi.org/10.1002/14651858.CD004350.pub2 Update in: Cochrane Database Syst Rev. 2012;10:CD004350.
• 4.Ashokka B, Loh MH, Tan CH, et al. Care of the pregnant woman with coro¬navirus disease 2019 in labor and delivery: anesthesia, emergency cesarean delivery, differential diagnosis in the acutely ill parturient, care of the new¬born, and protection of the healthcare personnel. Am J Obstet Gynecol. 2020; 223(1):m66-74.e3. https://doi.org/10.1016/j.ajog.2020.04.005
• 5.Patriti A, Baiocchi GL, Catena F, et al. Emergency general surgery in Italy during the COVID-19 outbreak: first survey from the real life. World J Emerg Surg. 2020; 15(1): 36. https://doi.org/10.1186/s13017-020-00314-3
• 6.Doglietto F, Vezzoli M, Gheza F, et al. Factors associated with surgical mor¬tality and complications among patients with and without coronavirus dis¬ease 2019 (COVID-19) in Italy. JAMA Surg. 2020; 155(8): 691-702. https://doi.org/10.1001/jamasurg.2020.2713
• 7.Aktas Yildirim S, Sarikaya ZT, Ulugol H, et al. Are surgical and non-operat¬ing room intervention safe in the COVID-19 pandemic? A retrospective study. Epidemiol Infect. 2021; 149: e210. https://doi.org/10.1017/S0950268821002119
• 8.Gao R, Liu B, Yang W, et al. Association of aternal sexually transmitted in-fections with risk of preterm birth in the United States. JAMA Netw Open. 2021; 4(11): e2133413. https://doi.org/10.1001/jamanetworkopen.2021.33413
• 9.de Souza Silva GA, da Silva SP, da Costa MAS, et al. SARS-CoV, MERS-CoV and SARS-CoV-2 infections in pregnancy and fetal development. J Gynecol Obstet Hum Reprod. 2020; 49(10): 101846. https://doi.org/10.1016/j.jogoh.2020.101846
• 10.Della Gatta AN, Rizzo R, Pilu G, et al . Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol. 2020; 223(1): 36-41. https://doi.org/10.1016/j.ajog.2020.04.013
• 11.Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020; 99(7): 823-9. https://doi.org/10.1111/aogs.13867
• 12.Handley SC, Gallagher K, Lindgren E, et al. Postpartum length of stay and hospital readmission before and during the coronavirus disease 2019 (COVID-19) pandemic. Obstet Gynecol. 2022; 139(3): 381-90. https://doi.org/10.1097/AOG.0000000000004687
• 13.Chmielewska B, Barratt I, Townsend R, et al. Effects of the COVID-19 pan¬demic on maternal and perinatal outcomes: a systematic review and meta-analysis. Lancet Glob Health. 2021; 9(6): e759-72. https://doi.org/10.1016/S2214-109X(21)00079-6
• 14.Shander A, Knight K, Thurer R, et al. Prevalence and outcomes of anemia in surgery: a systematic review of the literature. Am J Med. 2004; 116 Suppl 7A: 58S-69S. https://doi.org/10.1016/j.amjmed.2003.12.013
• 15.Smith ER, Oakley E, Grandner GW, et al. Clinical risk factors of adverse outcomes among women with COVID-19 in the pregnancy and postpartum period: a sequential, prospective meta-analysis. Am J Obstet Gynecol. 2023; 228(2): 161-77. https://doi.org/10.1016/j.ajog.2022.08.038
• 16.Eleje GU, Ugwu EO, Enebe JT, et al. Cesarean section rate and outcomes during and before the first wave of COVID-19 pandemic. SAGE Open Med. 2022; 10: 20503121221085453. https://doi.org/10.1177/20503121221085453
• 17.Li M, Yin H, Jin Z, et al. Impact of Wuhan lockdown on the indications of cesarean delivery and newborn weights during the epidemic period of COVID-19. PLoS One. 2020; 15(8): e0237420. https://doi.org/10.1371/journal.pone.0237420
• 18.Tran K, Cimon K, Severn M, et al. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a sys¬tematic review. PLoS One. 2012; 7(4): e35797. https://doi.org/10.1371/journal.pone.0035797
• 19.Ural SG, Tör İH. COVID-19 Pandemisi Döneminde Sezaryen ID Anestezisinde Tercihlerin Analizi: Retrospektif, Tek Merkezli Çalışma. Jour¬nal of Anesthesia/Anestezi Dergisi (JARSS). 2021; 29(2): 125-31. https://doi.org/10.5222/jarss.2021.86729
• 20.Jones E, Stewart F, Taylor B, et al. Early postnatal discharge from hospital for healthy mothers and term infants. Cochrane Database Syst Rev. 2021; 6(6): CD002958. https://doi.org/10.1002/14651858