Safety of Obstetric Surgeries at the Health Centres

Selection of anaesthesia: Although general anaesthesia is also safe, the risk ratio compared with regional anaesthesia has been reported to be 1.7. Use of regional anaesthesia for caesarean delivery is associated with improved maternal safety, as it eliminates fatal complications of aspiration, failed intubation and inadequate ventilation. All facilities provided either spinal anaesthesia or ketamine for all obstetric surgeries. General anaesthesia under intubation was not practiced. Obstetric surgeries included c-sections, laparotomy for ruptured uterus and ectopic pregnancies, cervical and severe perineal tears (third and fourth degrees). While the control health centres decreased the proportion of C-sections performed under ketamine by 20%, the intervention group decreased by almost 48% (Table 3). Except where the diagnoses were not well established, all obstetric haemorrhagic conditions requiring surgery were performed using ketamine.

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