Anesthetic management of cesarean section in COVID-19-positive pregnant women in Japan: Three case reports and review of the literature

SUGA Haruka

MIYOSHI Hirotsugu

ARATA Kumiko

SUMII Ayako

WATANABE Tomoyuki

KIDO Kenshiro

OTSUKI Sachiko

TSUTSUMI M Yasuo

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

Cesarean delivery may be performed if a pregnant woman develops coronavirus disease 2019 (COVID-19) in the prenatal period; however, perioperative management is controversial. Herein, we report the anesthetic management of cesarean sections in three pregnant women with COVID-19. In addition, we reviewed the literature on perioperative anesthesia management in pregnant women with COVID-19. Three pregnant women between the 37th and 38th weeks of gestation developed COVID-19 and were transferred to our hospital for cesarean section. Intraoperative spinal anesthesia was administered, and postoperative analgesia included intravenous morphine. Postoperatively, all patients were administered anticoagulant therapy. We used a negative pressure-controlled operating room for the cesarean sections, and the staff used Level 3 personal protective equipment with N95 masks, face shields, double gloves, full-body gowns, and shoe covers. None of the operating room staff, including the anesthesiologist, were infected with COVID-19 due to patient care. Spinal anesthesia, rather than general anesthesia, is recommended for cesarean sections in pregnant women with COVID-19. In addition to the risk of thrombosis, it is necessary to manage anesthesia in pregnant women infected with COVID-19 while considering accessibility to the ward for postoperative management and familiarity of ward staff.

Coronavirus disease 2019

Cesarean section

Spinal anesthesia

Analgesia

Thrombosis

eng

Hiroshima University Medical Press

Copyright (c) 2023 Hiroshima University Medical Press

[DOI] https://doi.org/10.24811/hjms.72.1-2_21 isIdenticalTo