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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (3): 628-630    DOI: 10.31083/j.ceog.2021.03.2446
Special Issue: CoVID-19 in OB/GYN
Original Research Previous articles | Next articles
Anesthesiologic management of pregnant women with SARS-COV-2 infection undergoing cesarean delivery
Antonio Coviello1, Concetta Posillipo1, Ludovica Golino1, Carlo De Angelis2, *(), Elisabetta Gragnano1, Gabriele Saccone1, Marilena Ianniello1, Gaetano Castellano3, Annachiara Marra1, Alfredo Maresca1, Maria Vargas1, Giuseppe Servillo1
1Department of Anesthesiology and Intensive Care Medicine, Policlinico, Federico II University Hospital, 80131 Naples, Italy
2Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, 00155 Rome, Italy
3Department of Anesthesiology and Intensive Care Medicine, Policlinico, Gemelli Molise Spa, 1 86100 Campobasso, Italy
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Abstract  
Background: Pregnant women are usually more susceptible to infection due to typical physiological and mechanical changes, such as increased heart rate, stroke volume and pulmonary residual capacity. The aim of this study was to evaluate an innovative anesthesiologic opioid-free management protocol in symptomatic pregnant women, with COVID-19 and with oxygen therapy, undergoing cesarean delivery with spinal anesthesia. Methods: With the patient in the sitting position, spinal anesthesia was performed at the L1–L2 level. Vertebral level has been identified starting from the sacrum, we counted the laminae in the caudal-to-cephalad direction, which was then marked with a surgical pen. The technique was performed in asepsis, in the subarachnoid space after vision of clear Cephalo-Spinal Fluid (CSF) in the spinal needle 27 Gauge, without letting out the CSF, bupivacaine 0.5% 10 mg, dexmedetomidine 10 μg and dexamethasone 4 mg was injected. Results: During the study period, 40 pregnant women with one or more symptoms and supplemental oxygen (FiO2 35–40%) who underwent cesarean delivery were included in the study. All pregnant women had pain visual analog scale (VAS) ≤3, and no pregnant women required rescue dose. Adverse effects, such as nausea, vomiting, shivering, or pruritus were not recorded in any case. After a mean of 2.5 hours from the spinal anesthesia, all the included women had a complete motility of the lower limbs and were able to mobilize independently within 12 hours after delivery. Mean time to first flatus was about 8 hours after delivery. Conclusions: Pregnant women in COVID-19 can safely receive intrathecal dexamethasone and dexmedetomidine during planned cesarean delivery.
Key words:  Pregnancy      Anesthesia      Delivery      COVID-19      SARS-COV-2      2019-nCOV      Cesarean delivery      Spinal anesthesia      Neuraxial anesthesia      Labour      Fetus      Pneumonia     
Submitted:  02 January 2021      Revised:  11 February 2021      Accepted:  23 March 2021      Published:  15 June 2021     
*Corresponding Author(s):  Carlo De Angelis     E-mail:  carlo.deangelis@uniroma1.it

Cite this article: 

Antonio Coviello, Concetta Posillipo, Ludovica Golino, Carlo De Angelis, Elisabetta Gragnano, Gabriele Saccone, Marilena Ianniello, Gaetano Castellano, Annachiara Marra, Alfredo Maresca, Maria Vargas, Giuseppe Servillo. Anesthesiologic management of pregnant women with SARS-COV-2 infection undergoing cesarean delivery. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(3): 628-630.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2021.03.2446     OR     https://ceog.imrpress.com/EN/Y2021/V48/I3/628

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