Health - Anesthesia during childbirth seen very safe

Megan Rauscher

NEW YORK (Reuters Health) - The odds of a woman dying from the anesthesia she may be given during childbirth have fallen to about one in a million, according to a study described at the American Society of Anesthesiologists annual meeting in Orlando, Florida.

The new finding "should be very reassuring for women," Dr. Joy L. Hawkins, professor of anesthesiology at the University of Colorado Denver School of Medicine, who led the study, told Reuters Health.

"Anesthetic deaths are a very rare cause of maternal mortality in the United States, but even one death is important and should be prevented," she said.

An analysis of data from the Centers for Disease Control and Prevention's ongoing Pregnancy Mortality Surveillance project for 1997 through 2002 suggest that anesthetic deaths hover around 1.1 maternal deaths per million live births, Hawkins told the conference.

Over the 6-year study period, a total of 49 pregnancy-related deaths due to anesthesia were reported. Thirty-one were associated with live births or still births and 16 were associated with abortion; one was an ectopic pregnancy and one had missing information.

Eighty percent of the anesthesia-related deaths during childbirth were associated with cesarean delivery.

Six of the anesthesia-related deaths occurred during general anesthesia and 18 during local or regional anesthesia -- for example, an epidural or spinal block. In seven cases, the type of anesthesia was unknown.

While past studies had indicated that general anesthesia was riskier than regional anesthetics for women during childbirth, the new data suggests that the safety of general anesthesia has improved, the study team notes.

"I think anesthesiologists have done a very good job of looking at the ways we could improve care, especially during general anesthesia," Hawkins said.

Hawkins cautioned, however, that improvements are still needed. While there has been a steady decline in death rates during general anesthesia, from 32.3 to 7.8 per million general anesthetics done for cesarean section over the 18 years ending in 2002, the rate for regional anesthesia has risen from 1.9 to 3.4 deaths per million regional anesthetics during that same period.

"We hope to continue working with the CDC to monitor these cases and look for further ways to improve," Hawkins said.