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

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.

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Authors

Contributions

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

Corresponding author

Correspondence to Shujuan Chu.

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The authors declare that they have no conflict of interest.

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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 (2021). https://doi.org/10.1007/s00404-021-06274-6

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Keywords

  • General anesthesia
  • Local anesthesia
  • Pulmonary arterial hypertension
  • Maternal outcome
  • Neonatal outcome
  • Cesarean section