Introduction:

The cardiovascular changes of pregnancy may place additional stress upon women with preexisting heart diseases, thus increasing peripartum morbidity and mortality. In this study, the effects of anesthetic technique on mothers and newborns were investigated in a retrospective analysis of parturients with cardiac diseases undergoing cesarean section between 2015 and 2017.

Methods:

After obtaining approval from the ethics committee, anesthetic, fetal, and maternal data from 63 pregnancies with cardiac disease in whom cesarean operations performed over a 3-year period between 2015 and 2017 were retrospectively obtained from Hospital of Medical School of Harran University medical records.

Results:

Thirty four (53.97%) pregnant women received general anesthesia, and Twenty nine (46.03%) received regional anesthesia (25 spinal and 4 epidural anesthesia; p=0.05). We determined that parturients with higher New York Heart Association (NYHA) classifications had higher general anesthesia rates. (p=0.030). Among cardiac parturients, valvular lesion rates were relatively higher (63.5%). The most frequent second cardiac disease was rhythm disturbance. Eight patients in this group received regional anesthesia and 2 patients received general anesthesia. The number of hospitalizations was significantly longer in patients with past cesarean section number 3 and above (p=0.009). When we examined correlation relation between continuous variables, the American Society of Anesthesiologists score decreased as the ejection fraction value increased (r=-311; p=0.013). As gestational week increased, the duration of postoperative intensive care was shortened. (r=-599; p=0.002).

Conclusion:

We determined that general and epidural anesthesia rates in parturients with cardiac diseases were similar; general anesthesia was preferred for parturients who had higher NYHA classifications. However, a multidisciplinary approach is needed.

Keywords: Pregnancy, cesarean section, anesthesia, cardiac diseases