Retrospective Analysis of Covid-19 Positive Parturients Posted for Caesarean Section in Tertiary Care Centre

Abstract

Background And Aims: Parturients posted for LSCS present with physiological changes due to pregnancy and gravid uterus, may have associated co-morbidities, superadded by COVID 19 infection poses a real challenge for an anesthesiologist. Urgency in obstetric anesthesia and extreme precautions needed to avoid this contagious disease further increase the burden on the anesthesiologist. This study focuses on perioperative presentation, management, and outcome of patients in a tertiary level hospital. Method: 329 pregnant females with RAT or RTPCR positive for COVID 19 and undergoing cesarean section from 1st May 2020 to 31st July 2021 were included in this retrospective observational study. Data was collected and analyzed from OT, ICU, WARD records, patient medical and electronic records, and maternal mortality data. Results: Amongst 329 parturients, 98.48%(324/329) received spinal anesthesia, one received epidural anesthesia (0.30%) and 1.21%(4/329) required general anesthesia. The incidence of hypotension was 5.77% (19/329), managed with inj. Mephentermine without inotropes. The intraoperative course was uneventful except for one case of CRA, revived successfully. Nine patients (2.73%) required ICU care. Oxygen support by either nasal prongs or face masks was given to 3.95% (13/329) patients. Three patients (0.91%) required NIV support and three patients (0.91%) required invasive ventilation postoperatively. The overall mortality was 0.61% (2/329). The mean duration of hospital stay was found to be 8.2 ± 5.03 days Conclusion: Neuraxial anesthesia remains a technique of choice for LSCS and can be safely employed in the parturients even with moderate pneumonia. General anesthesia can be reserved for patients of severe covid pneumonia.