Evidence map›Paper›PMID 39011056›Full record

ArticleEuropean journal of obstetrics & gynecology and reproductive biology: X2024

The anesthetic approach to repeated cesarean sections: A prospective cohort study.

Jacob Weinstein, Rasha Muhalwes, Alexander Ronenson, Stephen H Halpern, Sorina Grisaru-Granovsky, Tamer Akawi, Yaacov Gozal, Daniel Shatalin, Alexander Ioscovich

Abstract read
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In one paragraph

Article in European journal of obstetrics & gynecology and reproductive biology: X, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jacob WeinsteinDepartment of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with the Faculty of Medicine, The Hebrew University, 12 Shmu'el Bait Street, PO Box 3235, Jerusalem, Israel.
Rasha MuhalwesDepartment of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with the Faculty of Medicine, The Hebrew University, 12 Shmu'el Bait Street, PO Box 3235, Jerusalem, Israel.
Alexander RonensonDepartment of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with the Faculty of Medicine, The Hebrew University, 12 Shmu'el Bait Street, PO Box 3235, Jerusalem, Israel.
Stephen H HalpernDepartment of Anesthesia, University of Toronto and Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
Sorina Grisaru-GranovskyDepartment of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Faculty of Medicine, The Hebrew University, 12 Shmu'el Bait Street, PO Box 3235, Jerusalem, Israel.
Tamer AkawiDepartment of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with the Faculty of Medicine, The Hebrew University, 12 Shmu'el Bait Street, PO Box 3235, Jerusalem, Israel.
Yaacov GozalDepartment of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with the Faculty of Medicine, The Hebrew University, 12 Shmu'el Bait Street, PO Box 3235, Jerusalem, Israel.
Daniel ShatalinDepartment of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with the Faculty of Medicine, The Hebrew University, 12 Shmu'el Bait Street, PO Box 3235, Jerusalem, Israel.
Alexander IoscovichDepartment of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with the Faculty of Medicine, The Hebrew University, 12 Shmu'el Bait Street, PO Box 3235, Jerusalem, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Each repeat cesarean section (CS) potentially adds surgical complexity. The determination of appropriate anesthesia strategy to meet the surgical challenge is of crucial importance for the maternal and neonatal outcome. Study design: This prospective cohort study was conducted from 1-Jan-2021 to 31-Dec-2021 at a single large obstetric centre of all repeat CS. We compared the characteristics and the appropriateness of the anesthesia techniques for low-order repeat CS (LOR-CS) (1 or 2 previous CS) and high order repat CS (HOR-CS) group (3 or more repeat CS). Results: During the study period, 1057 parturients met the study entry criteria, with 821 parturients in the LOR-CS group and 236 parturients in the HOR-CS group. The use of spinal anesthesia was more common for HOR-CS 84.3%. Overall surgical time varied between LOR-CS (38 min, 29-49) and HOR-CS (42 min, 31-57) (p = 0.004).The rate of moderate and severe adhesions was relatively high in HOR-CS and the duration of overall surgical time for cases with mild adhesions was 38 min (29-48), for moderate adhesions was 44 min (34.8-56.5), and for severe adhesions was 56 min (44.8-74.3). There was no significant difference in the Estimated Blood Loss (EBL) between LOR-CS and HOR-CS, with values of 653 ± 292 ml vs. 660 ± 285 ml, respectively. Conclusion: Our data indicate that spinal anesthesia, standard monitoring and regular anesthetic setup are safe and suitable for the majority of HOR-CS, except in cases with high suspicion of placental accreta spectrum.

Indexed as

ComplicationsObstetric anesthesiaRepeat cesarean sectionSpinal anesthesia

Identifiers

PMID39011056
PMCPMC11247144

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.