Why do we need this research?
During a caesarean section, the mother needs anaesthesia to avoid pain. There are lots of different ways that anaesthesia can be given. These include general anaesthesia, where she is fully unconscious, or a regional anaesthetic such as an epidural or spinal injection, where only one part of the body is numbed.
Using general anaesthesia during a caesarean section can be risky for both mother and baby, so anaesthetists would prefer to not use it. However, for obese women, caesarean sections can be more complicated and take longer than expected. This can mean that women might end up having a general anaesthetic if their spinal or epidural anaesthetic wears off. Also, in emergencies, general anaesthesia may be the only option, as it tends to act quicker.
Right now, we don’t know for certain what the best type of anaesthetic is for obese mothers having a caesarean section. This can potentially mean that mothers receive anaesthetic that isn’t appropriate for them, which could cause problems for them and their baby.
What’s happening in this project?
In this study, researchers funded by Tommy’s have gathered data on thousands of caesarean section surgeries taking place in and around Edinburgh between 2011 and 2015. For each one, the team have collected data on the age and obesity of the mother, how long the surgery took, what kind of anaesthetic was used, and whether it was an emergency operation or not.
So far, the team have confirmed that for women who are obese (particularly if they are very obese), the time taken to give anaesthesia and for surgery increases significantly, compared to women with a normal weight. They have also found that in emergency caesarean sections, giving a ‘top-up’ epidural anaesthetic during surgery is almost as fast as a general anaesthetic. This is important, as it suggests that mothers could opt for the safer epidural anaesthetic instead of a general anaesthetic.
The team are now analysing the data to reveal any further findings which could be useful for anaesthetists.
What difference will this project make?
The findings from this project will help healthcare teams make better decisions about what kind of anaesthesia is best for each mother having a caesarean section. This will help to reduce the risks of surgery for both mother and baby, particularly in emergency situations.
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Tommy's funds research across the UK investigating the reasons for pregnancy complications and loss. If you're interested in being kept updated about our research and news from Tommy's, click here.
A recently published article, co-authored by Professor Catherine Williamson from Tommy’s Research Centre at King’s College London, suggests that certain pregnancy complications can indicate future health issues for women.
Tommy’s has received a grant from the UK Government’s Department for Health and Social Care to support the costs of its PregnancyHub information and support services throughout the summer, due to rising demand in the wake of coronavirus.
Although recruitment to some clinical trials had to be paused when coronavirus hit the UK, scientists at Tommy’s Research Centres across the UK are still hard at work, supporting women and families in our specialist clinics and sharing their latest studies with academic journals.
The day before Mother’s Day, and two days before the UK officially went into coronavirus lockdown, Zara Dawson found out she was having a miscarriage. Her third consecutive miscarriage in less than a year, and fourth consecutive loss, after losing her second son Jesse in 2018 to termination for medical reasons.