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Maternal and fetal outcomes following unplanned conversion to general anesthetic at elective cesarean section

Journal of Perinatology volume 35, pages 695–699 (2015)Cite this article

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Abstract

Objective:

To investigate risk factors predicting unplanned conversion to general anesthesia during elective cesarean section, and to examine maternal and fetal outcomes associated with unplanned conversion compared with other modes of anesthesia.

Study Design:

A retrospective cohort at a UK center (2008 to 2013). Women (4337) underwent elective cesarean section. Delivery outcomes were compared according to anesthesia type using logistic regression.

Result:

Women (1.6%) underwent unplanned conversion to general anesthetic. Unplanned conversion was associated with higher parity (odds ratio (OR) 3.82, confidence interval (CI; (1.58 to 9.62)) and maternal age ⩾40 (OR 4.40, CI (1.08 to 29.88)). Compared with spinal anesthetic, unplanned conversion was associated with increased likelihood of maternal hemorrhage ⩾1.5 l (OR 5.74, CI (1.90 to 14.01)) and delayed neonatal respiration (OR 4.76, CI (1.76 to 11.05)). Adverse outcomes were not significantly more likely compared with planned general anesthetic.

Conclusion:

Higher parity and maternal age are risk factors for unplanned conversion to general anesthetic. There is no increase in the likelihood of adverse outcomes with unplanned versus planned general anesthetic.

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Acknowledgements

Dr AR Aiken is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development grant for Infrastructure for Population Research at Princeton University, grant R24HD047879.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University of Cambridge, Addenbrooke’s Hospital, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, UK

    C E Aiken, J C Cole & J C Brockelsby

  2. Office of Population Research, Wallace Hall, Princeton University, Princeton, NJ, USA

    A R Aiken

  3. Department of Anaesthesia, Addenbrooke’s Hospital, Cambridge, UK

    J H Bamber

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  1. C E Aiken
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  2. A R Aiken
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Correspondence to C E Aiken.

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Aiken, C., Aiken, A., Cole, J. et al. Maternal and fetal outcomes following unplanned conversion to general anesthetic at elective cesarean section. J Perinatol 35, 695–699 (2015). https://doi.org/10.1038/jp.2015.62

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