Anesthetic management as a risk factor for postpartum hemorrhage after cesarean deliveries

作者：Chang Chuen Chau; Wang I Te; Chen Yi Hua; Lin Herng Ching^*

来源：American Journal of Obstetrics and Gynecology, 2011, 205(5): 462.e1.

DOI：10.1016/j.ajog.2011.06.068

• epidural anesthesia
• general anesthesia
• postpartum hemorrhage

OBJECTIVE: This population-based study aimed to compare the risk of postpartum hemorrhage (PPH) for patients who underwent cesarean section delivery (CS) with general vs spinal/epidural anesthesia.
STUDY DESIGN: We identified 67,328 women who had live singleton births by CS by linking the Taiwan National Health Insurance Research Dataset and the national birth certificate registry. Multivariate logistic regression was carried out to explore the relationship between anesthetic management type and PPH.
RESULTS: Women who received general anesthesia had a higher rate of PPH than women who received epidural anesthesia (5.1% vs 0.4%). The odds of PPH in women who had CS with general anesthesia were 8.15 times higher (95% confidence interval, 6.43-10.33) than for those who had CS with epidural anesthesia, after adjustment was made for the maternal and fetal characteristics.
CONCLUSION: The odds that women will experience cesarean PPH with general anesthesia are approximately 8.15 times higher than for women who undergo CS with epidural anesthesia.

• 出版日期2011-11