the anesthetic technique used.
According to Afolabi, maternal or neonatal death was not reported in any trial in the review, underscoring the relative safety of the Caesarean procedure.
"There appeared to be reduced blood loss with the use of regional anesthesia, however, and this applied to both spinal and epidural forms," she said. "Despite the fact that the review did not find a difference in the need for blood transfusions, this reduced blood loss may be relevant, as wound healing is slower in people with anemia."
"This review confirms what we have known for the past 20 years -- for delivery, regional anesthesia is safer than general anesthesia," said Charles J. Lockwood, M.D., professor and chair of the Department of Obstetrics, Gynecology and Reproductive Sciences at Yale University School of Medicine.
"The studies in the review were generally small and there was no way to blind the physicians caring for mothers or their infants as to the method of anesthesia -- which may introduce biases," said Lockwood.
The review found that more women preferred to have general anesthesia compared to epidural and spinal anesthesia for subsequent procedures.
Both Afolabi and Lockwood agree that this review is not likely to change patterns of practice of physicians delivering babies by Caesarean section and that it is largely the preference of the woman -- to remain awake during the birth of her child or not -- as well as due consideration of her medical condition that should determine whether her physician provides regional or general anesthesia during her C-section.
With general anesthesia, the woman is unconscious during the C-section and unaware of the birth of her baby. During regional anesthesia, the woman is awake during the procedure but is numbed in the area where the C-section is performed.
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