The Risk of Post-Partum Hemorrhage after CesareanSection with General versus Spinal/Epidural Anesthesia

Abstract

Blood loss of over 40 percent of total blood volume (approx. 2800 ml) is typically considered a’ life danger.’ It seems rational to introduce PPH protocols at an average blood loss far below this level, as the aim of management is to prevent hemorrhage from rising to the point that it is life-threatening
Objectives
Caesarean anesthetic treatment, which involves general anesthesia and spinal / epidural anesthesia, was seldom examined for the risks associated with postpartum hemorrhage and was focused on only a small number of cases from single hospital data sets. The function of different types of anesthesia in postpartum hemorrhage therefore needs to be further
explained.
Patients and methods
 This are a retrospective study on patients complicated by postpartum hemorrhage after cesarean section with history of type of anesthesia used; general or spinal or epidural to improve outcome of cesarean section. We included all women complicated by postpartum hemorrhage after cesarean section and collect data about the anesthesia used during cesarean section and also recorded other risk factors for postpartum hemorrhage if recorded in files in antenatal care sheet and the
intraoperative circumstances as recorded in the operative sheet of the patient. Heart rates and blood pressures of patients of both groups were measured before delivery and at 1 min interval for 15 min after injection of oxytocin. Uterine contractility was assessed for both groups at 1,2,4,6,8,10 and 15 min after oxytocin injection.
Results
 Our results showed that the age of the studied group ranged from 18 to 40 years with mean 23.97 years. Regarding parity 44.5% of them had one child and 36.7% of them had two, 42.3% of the studied group had general anesthesia and 57.7% of them had spinal. Also 82.2% of the cases were previous and 17.8% of them were emergent.
Conclusion
Anesthetic techniques might be affected by the possibility of bleeding or concern. We found that women who have undergone general anesthesia have a higher risk of postpartum hemorrhage compared with women who have received epidural,
spinal anesthesia