Retrospective analysis of anesthesia for hypertensive disorders in pregnancy at University of Ilorin Teaching Hospital, Kwara State

Background: Hypertensive disorders are one of the most common medical complications of pregnancy. It is a major cause of fetomaternal morbidity and mortality. Objectives: This article compares the clinical outcome of anesthetic techniques for parturients with hypertensive disorder undergoing cesarean section. Methods: We conducted a retrospective review of the medical records of patients with hypertensive disorders in pregnancy, who underwent cesarean section from January 2016 to December 2017. Data collected included demographic profiles, specific hypertensive disorders, anesthetic techniques, and maternal and neonatal outcome. Result: Over the reviewed period, 1294 cesarean sections were done, out of which 95 (7.3%) patients had hypertensive disorders in pregnancy. Preeclampsia was the most common hypertensive disorder (45.3%) and it was more common among the multiparus patients. Eight-two patients (86.3%) underwent subarachnoid block with 0.5% heavy bupivacaine, 10 patients (10.5%) had general anesthesia with relaxant technique using isoflurane as the volatile agent, whereas three patients (3.2%) had epidural block with 0.5% plain bupivacaine. Eighty-six patients (90.5%) were done as emergency whereas nine patients (9.5%) were done as elective. A total of 82 (86.3%) neonates had good APGAR score of >7. There was no significant difference between the anesthetic techniques and neonatal outcome, P = 0.642. The proportion of blood loss was more during emergency surgeries. There was no statistical significant difference between the nature of surgery and estimated blood loss, P = 0.691. Out of the 95 parturient, 12 (12.6%) had hypotension that necessitated use of vasopressor (ephedrine), out of which 11 cases were done as emergency whereas one was done as elective. There was no significant difference between the nature of the surgery and the use of vasopressor, P = 0.942. Conclusion: The choice of anesthesia did not have a significant difference on maternal and neonatal outcome following cesarean section in parturient with hypertensive disorders in pregnancy.