By Megan Rauscher
The odds of a woman dying from the anaesthesia she may be given during childbirth have fallen to about one in a million, according to a study described at the American Society of Anaesthesiologists annual meeting in Orlando, Florida.
The new finding "should be very reassuring for women," Dr. Joy L. Hawkins, professor of anaesthesiology at the University of Colorado Denver School of Medicine, who led the study, told Reuters Health.
"Anaesthetic 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 Centres for Disease Control and Prevention's ongoing Pregnancy Mortality Surveillance project for 1997 through 2002 suggest that anaesthetic deaths hover around 1,1 maternal deaths per million live births, Hawkins told the conference.
Over the six-year study period, a total of 49 pregnancy-related deaths due to anaesthesia 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 anaesthesia-related deaths during childbirth were associated with cesarean delivery.
Six of the anaesthesia-related deaths occurred during general anaesthesia and 18 during local or regional anaesthesia - for example, an epidural or spinal block. In seven cases, the type of anaesthesia was unknown.
While past studies had indicated that general anaesthesia was riskier than regional anaesthetics for women during childbirth, the new data suggests that the safety of general anaesthesia has improved, the study team notes.
"I think anaesthesiologists have done a very good job of looking at the ways we could improve care, especially during general anaesthesia," Hawkins said.
Hawkins cautioned, however, that improvements are still needed. While there has been a steady decline in death rates during general anaesthesia, from 32,3 to 7,8 per million general anaesthetics done for cesarean section over the 18 years ending in 2002, the rate for regional anaesthesia has risen from 1,9 to 3,4 deaths per million regional anaesthetics 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.