ArticleAnesthesia and pain medicine2022
Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data.
Article in Anesthesia and pain medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 6 citations in OpenAlex.
- The differential role of anesthetic technique by etiology of postpartum hemorrhage: a dual-cohort analysis of emergency cesarean delivery and placenta accreta spectrum.Frontiers in medicine · 2026Article
- Risk factors for severe postpartum hemorrhage requiring blood transfusion after cesarean delivery for twin pregnancy: a nationwide cohort study.Anesthesia and pain medicine · 2023Article
- Visual estimation of blood loss versus quantitative blood loss for maternal outcomes related to obstetrical hemorrhage.Proceedings (Baylor University. Medical Center) · 2023Article
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5 authors at 1 institution in 1 country.
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Abstract
backgroundPostpartum hemorrhage (PPH) is a major cause of maternal mortality and the risk factors for PPH differ among studies. In this large-scale study, we investigated whether the anesthetic method used was associated with PPH after cesarean section.
methodsWe extracted data on cesarean sections performed between January 2008 and June 2013 from the National Health Insurance Service database. The anesthetic methods were categorized into general, spinal and epidural anesthesia. To compare the likelihood of PPH among deliveries using different anesthetic methods, crude and adjusted odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression analysis.
resultsData from 330,324 cesarean sections were analyzed, and 21,636 cases of PPH were identified. Univariate analysis showed that general and epidural anesthesia increased the risk of PPH compared to spinal anesthesia. The OR for PPH was highest for morbidly adherent placenta, followed by placenta previa, placental abruption, and hypertension. When other clinical covariates were controlled for, general and epidural anesthesia still remained significant risk factors for PPH compared to spinal anesthesia.
conclusionsThis study showed that general and epidural anesthesia elevated the risk of PPH compared to spinal anesthesia during cesarean section. Since we could not consider the potential bias of group differences in indications, more in-depth clinical trials are needed to validate our findings. Obstetric factors such as placental abnormalities had high odds ratios and thus are more important than the choice of anesthetic method, which should be based on the patient's clinical condition and institutional resources.
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