Background
The low platelet count, associated with HELLP syndrome (HS) has often favored the choice of general anesthesia for the cesarean section (CS); however, general anesthesia in such cases is not a risk-free approach. General anesthesia is associated with increased risk of complications.
Aim of work
To evaluate the safety of general anesthesia in patients with class II HS scheduled for elective CS as regards maternal and fetal complications.
Patients and methods
In this prospective, observational study carried out at the maternal hospital in Assiut University Hospitals. We included all patients with class II HS scheduled for elective CS under general anesthesia who were admitted to the women health hospital during the 1 year. The study collected data about the incidence of neurological complications, incidence of intraoperative hemodynamic instability (hypotension, hypertension, bradycardia, and tachycardia), and effect of general anesthesia on fetal outcome including umbilical blood gas and Apgar score.
Results
The incidence of intraoperative and postoperative complications is higher in HS patients compared with CS in normal parturients as regards intraoperative hypertension, tachycardia, and postoperative neurological complications.
Conclusion
HS patients are at an increased risk of complications during CS under general anesthesia and alternative types of anesthesia like spinal or epidural anesthesia should be considered.