Feto-Maternal Outcome of General and Spinal Anesthesia Among Pregnant Mothers Who Undergo Category One Cesarean Sections –A Comparative Cross-Sectional Study at Jimma University Medical Center, 2022.

Abstract Background Category one cesarean section is performed in the most urgent conditions for the fetus or mother and sometimes in both cases. Currently, the practice of anesthesia for emergency cesarean sections is becoming spinal over general anesthesia due to adverse feto-maternal outcomes. The aim of the study was to compare feto-maternal outcomes under general and spinal anesthesia during category one cesarean deliveries at Jimma University Medical Center. Methods A comparative cross-sectional study was conducted at Jimma University Medical Center from August 20 to November 01, 2022. The study included 72 category one pregnant mothers. Sociodemographic, indication for category one cesarean delivery, DDI, perioperative maternal vital signs, intraoperative blood loss and need for transfusion of blood and ICU admissions were noted to compare maternal outcomes under general and spinal anesthesia. On the other hand, for comparison of newborn outcomes, variables such as APGAR scores at one and five minutes, need for bag mask ventilation, intubation and NICU admissions were used. Data were entered into epiData 4.6 software and exported to IBM SPSS Statistics 26 for analysis. Independent sample Student’s t test was used for comparison of normally distributed continuous data, and the Mann-Whitney U test was used for non-normally distributed data. On the other hand, for comparison of categorical data, chi-square and Fisher’s exact tests were used. A p value less than 0.05 was used to indicate a statistically significant difference in outcomes between groups. Result The ages of the participants were comparable between general and spinal anesthesia, with means of 27.86 ± 5.42 and 26.27 ± 6.77 years, respectively; p = 0.344. The DDI and one- and five- minute Apgar scores were significantly different between the general and spinal anesthesia groups. There was no significant difference between general and spinal anesthesia regarding neonatal and maternal death. Conclusion General anesthesia may be considered faster than spinal anesthesia during emergency cesarean section deliveries. However, it was found that; it is associated with fetal and maternal morbidity compared to spinal anesthesia. Therefore, we recommend spinal anesthesia over general anesthesia to achieve a better outcome.