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Effects of different anesthesia methods on maternal and neonatal outcomes in pregnant patients with pulmonary arterial hypertension: a meta-analysis

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Abstract

Purpose

To investigate the effects of different anesthesia methods on maternal and neonatal outcomes in pregnant patients with pulmonary arterial hypertension (PAH).

Methods

We searched PubMed, Excerpta Medica Database (EMBASE), Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wanfang and QVIP for investigating the effects of general anesthesia (GA) and local anesthesia (LA) in pregnant patients with PAH. Results were expressed as weighted mean difference (WMD) or risk ratio (RR) with 95% confidence intervals (CIs). Publication bias was assessed by the Begg’s test.

Results

Totally, 18 articles containing 628 LA and 481 GA patients were involved in our study. The postoperative blood oxygen saturation (WMD =  − 4.040, 95%CI: − 5.505 to − 2.576) and maternal mortality rate (RR = 0.507, 95%CI: 0.300–0.858) were lower in LA group than those in GA group. The postoperative systolic blood pressure (WMD = 15.647, 95%CI: 13.294–18.000) and postoperative diastolic blood pressure (WMD = 6.758, 95%CI: 5.715–7.802) were high in LA group compared with those in GA group. The mechanical ventilation time (WMD =  − 4.112, 95%CI: − 4.655 to − 3.569), ICU admission time (WMD =  − 4.176, 95%CI: − 4.523 to − 3.828), length of stay (WMD = −7.289, 95%CI: −7.799–6.779) were shorter in LA group than those in GA group. All P values were < 0.05.

Conclusions

LA is superior to GA in regards to the postoperative blood oxygen saturation, the postoperative systolic blood pressure, postoperative diastolic blood pressure, the mechanical ventilation time, ICU admission time, length of stay and the maternal mortality rate.

Registration number

osf.io/juybq (https://osf.io/search/).

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

References

  1. Farber HW, Loscalzo J (2004) Pulmonary arterial hypertension. N Engl J Med 351(16):1655–1665

    Article  CAS  Google Scholar 

  2. Simonneau G, Robbins IM, Beghetti M, Channick RN, Delcroix M, Denton CP et al (2009) Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 54(1 Suppl):S43-54

    Article  Google Scholar 

  3. Rashidi F, Sate H (2018) Pregnancy outcome in a pregnant patient with idiopathic Pulmonary Arterial Hypertension: a case report and review of the literature. J Med Case Reports 12(1):31

    Article  Google Scholar 

  4. Olsson KM, Channick R (2016) Pregnancy in pulmonary arterial hypertension. Eur Respir Rev 25(142):431–437

    Article  Google Scholar 

  5. Weiss BM, Zemp L, Seifert B, Hess OM (1998) Outcome of pulmonary vascular disease in pregnancy: a systematic overview from 1978 through 1996. J Am Coll Cardiol 31(7):1650–1657

    Article  CAS  Google Scholar 

  6. Sharma K, Afshar YR, Bairey-Merz CN, Tapson V, Zakowski M, Kilpatrick SJ (2016) Guidelines and consensus: statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research Institute. Pulm Circ 6(1):143

    Article  CAS  Google Scholar 

  7. Behdad S, Hajiesmaeili MR, Abbasi HR, Ayatollahi V, Khadiv Z, Sedaghat A (2013) Analgesic effects of intravenous ketamine during spinal anesthesia in pregnant women undergone caesarean section; a randomized clinical trial. Anesth Pain Med 3(2):230–233

    Article  Google Scholar 

  8. Wang Y, Xu H, Li H, Liu Y, Bai Q (2018) Association of hemodynamics during caesarean section, outcomes after caesarean section and hormone changes with different anesthesia in pregnant women with severe pulmonary arterial hypertension. Exp Ther Med 15(6):4731–4736

    PubMed  PubMed Central  Google Scholar 

  9. Lumbiganon P, Moe H, Kamsa-Ard S, Rattanakanokchai S, Laopaiboon M, Kietpeerakool C et al (2020) Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys. Sci Rep 10(1):10176

    Article  CAS  Google Scholar 

  10. Han H, Francis JK, Spitzer Y, Reddy S (2019) Anesthetic management of parturients with pulmonary hypertension undergoing cesarean deliveries. J Clin Anesth 57:79

    Article  Google Scholar 

  11. Patel S, Weierstahl KL, Shah S, Fidkowski CW (2016) Anesthetic management for cesarean delivery in a patient with pulmonary emboli, pulmonary hypertension, and right ventricular failure. A A Case Rep 7(7):146–149

    Article  Google Scholar 

  12. Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A et al (2013) Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 62(25 Suppl):D34-41

    Article  Google Scholar 

  13. Sun X, Feng J, Shi J (2018) Pregnancy and pulmonary hypertension: an exploratory analysis of risk factors and outcomes. Medicine 97(44):e13035

    Article  Google Scholar 

  14. Bian H (2017) Effects of different anesthesia methods on cesarean section in patients with severe pulmonary hypertension during pregnancy. Chinese J Woman Child Health Res 28(6):684–686

    Google Scholar 

  15. Cao X (2018) Effects of different anesthesia methods on cesarean section in pregnant women with severe pulmonary hypertension. Henan Med Res 27(16):2980–2981

    Google Scholar 

  16. Dong S (2018) Anesthesia management for pregnant women with moderate to severe pulmonary hypertension. J Clin Anesthesiol 34(8):813–815

    Google Scholar 

  17. Jing H (2012) Experience in anesthesia management of cesarean section in 20 cases of pregnancy complicated with eisenmenger syndrome. J Cardiov Pulmonary Dis 31(2):113–116

    Google Scholar 

  18. Kong M (2019) Analysis of the influence of different anesthesia methods on the outcome after cesarean section in pregnant patients with severe pulmonary hypertension. Women’s Health Res 4(8):80–81

    Google Scholar 

  19. Li F (2019) Anesthesia analysis of cesarean section in pregnant women with severe pulmonary hypertension. China Continuing Med Edu 11(23):65–67

    Google Scholar 

  20. Li Y (2020) Comparison of the effects of combined lumbar anesthesia and general anesthesia on cesarean section in pregnant women with severe pulmonary hypertension. Henan Med Res 29(5):807–808

    Google Scholar 

  21. Ma G (2018) Analysis of application of spinal anesthesia for severe pulmonary arterial hypertension in pregnancy. Zhejiang J Traumatic Surg 23(2):401–402

    Google Scholar 

  22. Tan Y (2017) Effects of different anesthetic methods on cesarean section for pregnant women with complicating pulmonary arterial hypertension. J Modern Med Health 33(19):2900–2903

    Google Scholar 

  23. Xie J (2015) Effects of different anesthesia on cesarean outcomes for pregnant women with severe pulmonary hypertension. J Pr Obstet Gynecol 31(4):296–298

    CAS  Google Scholar 

  24. Xu Y (2019) Observation of the effect of combined lumbar anesthesia and epidural anesthesia on hemodynamics and outcomes of delivery in pregnant patients with severe pulmonary hypertension. J Med Theory Pr 32(22):3682–3683

    Google Scholar 

  25. Yang X (2017) Effect of combined lumbar anesthesia and epidural anesthesia on hemodynamics and outcomes of delivery in pregnant patients with severe pulmonary hypertension pregnancy. Henan Med Res 26(10):1816–1817

    Google Scholar 

  26. Yao M (2017) Analysis of the effect of different anesthesia methods on outcomes of cesarean section for pregnant patients with pulmonary arterial hypertension. Guide China Med 15(7):156–157

    Google Scholar 

  27. Zhang M (2016) The effect of different anesthesia methods on hemodynamics and postoperative outcomes during cesarean section in pregnant women with severe pulmonary hypertension. Chinese J Lab Diagn 20(9):1576–1579

    Google Scholar 

  28. Zhang Q (2015) Anesthesia experience of caesarean section for pregnant women with pulmonary hypertension. Shaanxi Med J 44(2):167–169

    Google Scholar 

  29. Zong X (2019) Analysis of the effect of different anesthesia methods on maternal and neonatal outcomes of cesarean section with severe pulmonary hypertension during pregnancy. J Clin Med 6(4):42–43

    Google Scholar 

  30. Martin SR, Edwards A (2019) Pulmonary hypertension and pregnancy. Obstet Gynecol 134(5):974–987

    Article  Google Scholar 

  31. Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A et al (2015) 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the joint task force for the diagnosis and treatment of pulmonary hypertension of the european society of cardiology (ESC) and the European respiratory society (ERS): endorsed by: association for european paediatric and congenital cardiology (AEPC), international society for heart and lung transplantation (ISHLT). Eur Respir J 46(4):903–975

    Article  Google Scholar 

  32. Wang J (2020) Anesthesia for pregnant women with pulmonary hypertension. J Cardiothorac Vasc Anesth 24:1053

    Google Scholar 

  33. Aregawi A, Terefe T, Admasu W, Akalu L (2018) Comparing the effect of spinal and general anaesthesia for pre-eclamptic mothers who underwent caesarean delivery in a tertiary, addis ababa. Ethiopia Ethiop J Health Sci 28(4):443–450

    PubMed  Google Scholar 

  34. Sarkar MS, Desai PM (2018) Pulmonary hypertension and cardiac anesthesia: anesthesiologist’s perspective. Ann Card Anaesth 21(2):116–122

    PubMed  PubMed Central  Google Scholar 

  35. Bédard E, Dimopoulos K, Gatzoulis M (2009) Has there been any progress made on pregnancy outcomes among women with pulmonary arterial hypertension? Eur Heart J 30(3):256–265

    Article  Google Scholar 

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Author notes

  1. Yu Ming and Zhouyang Wu contributed equally to this work

Authors and Affiliations

  1. College of Medicine and Health Science, Wuhan Polytechnic University, Wuhan, 430023, Hubei, China

    Yu Ming

  2. Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China

    Zhouyang Wu, Zhilin Wu & Shujuan Chu

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  1. Yu Ming
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  2. Zhouyang Wu
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Contributions

YM: Study design, Manuscript writing. ZW: Data collection, analysis and interpretation. ZW: Data collection, analysis and interpretation. SC: Manuscript review and edit.

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Correspondence to Shujuan Chu.

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Ming, Y., Wu, Z., Wu, Z. et al. Effects of different anesthesia methods on maternal and neonatal outcomes in pregnant patients with pulmonary arterial hypertension: a meta-analysis. Arch Gynecol Obstet 306, 7–15 (2022). https://doi.org/10.1007/s00404-021-06274-6

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  • DOI: https://doi.org/10.1007/s00404-021-06274-6

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