Perioperative Outcome of Jaundiced Parturients undergoing Caesarian Section - A Retrospective Analysis

Abstract

Background: This study aims to retrospectively evaluate the causes, anaesthetic management and perioperative outcome of pregnant women with jaundice undergoing Caesarean section in a tertiary care hospital in India.

Patients and Methods: The medical records of all pregnant women with jaundice who underwent caesarian section in our hospital between March 2005 and February 2015 were analysed.

Results: Analysis revealed a 7-fold rise in the incidence of parturients with jaundice undergoing Caesarian section in February 2015, when compared to the incidence in March 2005. 38.3% of the patients had acute fatty liver of pregnancy (AFLP), while HELLP Syndrome occurred in 23.8%. 14.2% of the patients had jaundice due to cholestasis of pregnancy. Jaundice was due to infective and congenital causes in 14.2% and 9.5% cases, respectively. 81% of the cases came as emergencies while the remaining 19% were booked cases. 61.9% received general anaesthesia, while the surgery was done under spinal in 38.1% of patients. Perioperative complications were coagulopathy (42.9%), hypoglycemia (23.8%), uterine atonicity (14.3%), dyselectrolytemias (9.5%), respiratory problems (9.5%), encephalopathy (9.5%) and renal failure (4.8%).

Conclusion: Early anticipation and intensive supportive management are critical for improving the perioperative outcomes in pregnant jaundiced women undergoing caesarian section.