Retrospective evaluation of anesthesia methods applied in pregnancy with case diseases who have caesarean operation between 2015-2019 at A university hospital

Introduction and Objective: Although the majority of pregnant women in our country are young and healthy women, today, more women with heart disease come across anesthesiologists as pregnant, due to advances in surgical techniques and drug therapies.. In Medical Faculty Hospitals of Dicle University, 150 patients with heart disease who had a cesarean operation between January 2015 and December 2019 were examined and it was aimed to evaluate the results in the light of the literature. Materials and Methods: Demographic characteristics, ASA scoring, age, gestational week, current heart disease, additional disease, pulmonary artery pressure, ejection fraction, number of cesarean sections, length of stay in intensive care, type of anesthesia, 1st and 5th minute APGAR score of the baby recorded separately for each of 150 patients included in the study. Results: In our study; It was determined that spinal anesthesia was preferred in 72% of the cases, valvular diseases were the most common in cardiac diseases with 94% and maternal mortality was not observed. The average length of stay in the intensive care unit was 2 days in pregnant women under general anesthesia, and 1 day in pregnant women under spinal anesthesia. We found that 1st and 5th minutes APGAR scores of babies were higher in the spinal anesthesia group. APGAR scores in the 1st and 5th minutes were negatively correlated with the ASA score (r -, 194; r -, 167). A positive correlation was observed between the 5th minute APGAR score and the mother's EF score (r, 181). Conclusion: In our study, it was seen that general anesthesia was preferred for cesarean operations, since patients with high Pulmonary Artery Pressure (PAP) values are generally patients with poor general condition and complicated patients with cardiac disease (most pregnant women have more than one cardiac disease). We attributed that the low APGAR scores in the general anesthesia group; patients undergoing C / S under general anesthesia had bad cardiac and comorbid diseases, high PAP, low EF and high ASA scores. Although we we achieved important results with our study, we think that there is a need for large prospective studies on anesthesia applications in pregnant women with heart disease. Pregnant women with heart disease should be followed up and treated with a multidisciplinary approach. We believe that maternal and neonatal risks will decrease with experienced teams (cardiology, obstetrics, anesthesia and neonatal specialists).