Anaesthetic Related Peri-Operative Complications During Caesarean Delivery at the University Teaching Hospital, Lusaka, Zambia
Bibliographic record
Abstract
Background: Caesarean deliveries are increasingly performed at the University Teaching Hospital (UTH), Lusaka, with a 2012 audit report indicating a rate of 17.8%.The procedure is a major surgical intervention and results in higher morbidity than vaginal delivery. Part of this morbidity and mortality during caesarean delivery is that resulting from the anaesthesia relating to the surgery. However, information on the extent of anaesthetic related complications associated with caesarean deliveries in low resource settings such as at UTH is lacking. This study endeavored to explore this aspect. Objective: To determine the frequency of anaesthetic related perioperative complications during caesarean delivery at the UTH, Lusaka, Zambia Study Design: A prospective observational study documenting the anaesthetic related complications in women undergoing caesarean delivery at UTH. 246 consecutive parturients undergoing caesarean deliveries were enrolled in the study. Methodology: All women who presented for caesarean delivery at UTH in Lusaka, Zambia from January 12, 2014 to July 12, 2014 and met the inclusion criteria were recruited into the study. Information on the patient and her management was obtained from the patient’s medical records. Participants were followed up from the time they were taken into theatre, during the procedure until the time they left the recovery room post operatively, and any complication observed was documented. Hypotension, possible aspiration, failed intubation, conversion from spinal to general anaesthesia, severe hypoxemia and death were the main outcome measures. A descriptive analysis was performed. All significant variables were included in the final multivariable logistic model. All tests were set at 95% confidence interval (CI) and a P- value of <0.05 was considered statistically significant. Results: No mortality was recorded out of the 246 parturients enrolled for the study. The average age was 28 years.Thirty-four cases (13.8%) received general anaesthetic while 212 cases (86.2%) had spinal anaesthetic. Obstructed labour 79 cases (32.1%) and previous caesarean sections 68 cases (27.6%) were among the indications for caesarean deliveries. Perioperative complications recorded included, 172 cases (69.9%) of hypotension, 6 cases (11.1%) had failed intubation, 5cases (9.3%) possibly aspirated, 20 cases (9.4%) had failed spinal technique needing conversion to general anaesthetic, 6 cases (3.1%) had high spinal block. Severe hypoxemia intraoperatively and postoperatively was noted in 16 cases (6.5%) and 7 cases (2.8%) respectively. There were no statistically significant associations among the complications with age of parturients, ASA status, grade of anaesthetist, category of caesarean sections, indication for caesarean sections or gestational age. Conclusion: There are many anaesthetic related complications during caesarean sections occurring at UTH. Future studies are needed to solely look into factors contributing to each of the complication at UTH.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".