Anesthesia Considerations for Pregnant People With COVID-19 Infection

Safety of spinal anesthesia in pregnant vaccinated with one or two doses of the BNT162b2 vaccine: A retrospective observational cohort study

Purpose

To evaluate the safety of spinal anesthesia in pregnant women who underwent cesarean section during the Covid-19 pandemia and were immunized with the BNT162b2 vaccine.

Methods

Historical cohort study that included three groups: non-vaccinated pregnant with no history of acute or previous Covid-19 [NV (n = 70)], vaccinated with one dose [1D (n = 65)] or two doses of BNT162b2 [2D (n = 45)], who underwent cesarean section with spinal anesthesia. Variables with normal distribution were analyzed with ANOVA. When one or more groups had non-normal distribution, the Kruskal-Wallis test was used. For categorical variables, the chi-square test or Kruskal-Wallis test was performed. When any variable had a frequency of less than five, the two-tailed Fisher's exact test with the Freeman-Halton extension was used. The significance level considered was p < .05.

Results

Apparently there is no interaction between BNT162b2 and the drugs most commonly used in spinal anesthesia for cesarean delivery. Conclusion: Performing spinal anesthesia in patients immunized with BNT162b2 does not seem to result in significant differences in outcomes compared to those not vaccinated. Apparently there is no need to change the standards of performing spinal anesthesia in patients vaccinated with the BNT162b2 vaccine.

Regional Anesthesia Conversion to General Anesthesia during Cesarean Section of a Woman with Antepartum Hemorrhage due to Placenta Previa and Ovarian Cyst with Moderate Confirmed COVID-19: A

Physiological changes during pregnancy and COVID-19 may affect one another. This report presents a 37-year-old female G4P10021 with gestational age 37+2 weeks infected with COVID-19 in Dr. Moewardi Hospital Surakarta, Central Java, Indonesia. The patient was diagnosed with antepartum hemorrhage due to total placenta previa with low-risk Morbidly Adherent Placenta score, a history of cesarean section, and ovarian cyst. The patient underwent conversion from spinal anesthesia to general anesthesia. Within 40 min after spinal anesthesia, the patient complained shortness of breath, which then worsened into decreased consciousness and inadequate spontaneous breathing. This may be complicated by the COVID-19 infection which has several effects on pregnancy.