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Significant improvement seen in anesthesia-related C-section complications

In New York, the annual overall rate of anesthesia-related complications among women having cesarean deliveries decreased by 25% since 2003, according to recently published data.

“Cesarean delivery is the most commonly performed inpatient surgical procedure in the United States, with 1.3 million cesareans being performed under epidural, spinal or general anesthesia each year. Women giving birth by cesarean delivery are generally at an increased risk for experiencing complications from anesthesia compared to women who deliver vaginally. However, our research shows anesthesia-related outcomes in cesarean deliveries have significantly improved,” Jean Guglielminotti, MD, PhD, postdoctoral research fellow, department of anesthesiology, Columbia University Medical Center, New York, said in a press release.  

Guglielminotti and colleagues analyzed data from the State Inpatient Database for New York from 2003 to 2012 to assess trends in anesthesia-related adverse events in cesarean delivery. Overall, 785,854 cesarean deliveries were included in the analysis.

Results demonstrated that 5,715 cesarean deliveries had at least one anesthesia-related adverse event (730 per 100,000; 95% CI, 710-750), and 7,040 had at least one perioperative complication (890 per 100,000; 95% CI, 870-920).

In 2012, the overall rate of anesthesia-related adverse events was 660 per 100,000 deliveries, down from 890 per 100,000 in 2003 (P < .0001).

Minor adverse events decreased by 23% and major adverse events decreased by 43% from 3004.

The rate of anesthesia-related adverse events from general anesthesia remained stable throughout the study period.

A 47% increase in nonanesthetic complications was seen from 2003.

The researchers noted that while the decrease in anesthesia-related adverse events is a good step, the increase in nonanesthesia-related perioperative morbidity and lack of decrease in general anesthesia–related adverse events are particularly troubling due to the effect on patient safety they could have.

“Over the last 2 decades, obstetric anesthesia providers have focused on improving the quality and safety of care provided to expectant mothers while providing pain relief during labor and safe anesthesia for cesarean delivery. Our research highlights the importance and success of intervention programs to improve obstetric anesthesia care. This is all the more important with the high cesarean delivery rate in the U.S. and the increase in maternal age, chronic maternal diseases and high-risk pregnancies,” Guglielminotti said in a press release. – by Casey Hower

Disclosures: The researchers report no relevant financial disclosures.