The Spinal Anesthesia-Related Complications in Cesarean Deliveries: Evidence from a Low-Resource Maternity Hospital in Sudan
DOI:
https://doi.org/10.59692/5m7vnp92Keywords:
Spinal anesthesia, Cesarean delivery, Obstetric anesthesia, Complications, Meningitis, Post-dural puncture headache, Sudan, Low-ResourceAbstract
Background: Spinal anesthesia (SA) is widely used for cesarean delivery (CD) due to its safety and efficacy; however, it is not free of complications. In low-resource settings where anesthetic care is often delivered by non-physician providers, SA-related adverse outcomes may be underestimated or underreported. This study aimed to determine the prevalence and risk factors of SA-related complications among women undergoing CD at Dongola Maternity Hospital in Northern Sudan.
Methods: A descriptive cross-sectional study was conducted at Dongola Maternity Hospital between March and August 2021. A total of 384 women who underwent CD under SA were selected by convenience sampling. Data were collected using structured questionnaires, patient interviews, and chart reviews. Participants were followed intraoperatively, at discharge, and two weeks postoperatively. Descriptive statistics, Chi-square tests, and binary logistic regression were performed using SPSS version 24. A p-value < 0.05 was considered statistically significant.
Results: Of the 384 women included, 57 (14.8%) experienced one or more SA-related complications. The most frequent were nausea (8.6%), post-dural puncture headache (6.3%), post-spinal meningitis (3.1%), hypotension (1.3%), and transient neurological symptoms (0.8%). Two maternal deaths (0.5%) were attributed to SA-related complications. Logistic regression identified the following independent predictors: preterm gestational age (AOR = 3.48; 95% CI: 1.42–8.54), category 2 (AOR = 5.59) and category 3 (AOR = 2.34) urgency of CD, crystalloid co-loading (AOR = 2.25), and fluid volume >2 liters (AOR = 3.81). A history of prior SA complications showed a marginal association (AOR = 2.51; p = 0.090).
Conclusion: SA-related complications are not uncommon and can be serious in low-resource settings. Preterm delivery, surgical urgency, and fluid management practices significantly increase risk. Improved aseptic techniques, stricter procedural protocols, and enhanced training for anesthesia providers are essential to minimize these complications.
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Copyright (c) 2026 Thoraya Salah Murtada Sidahmed, Mohamed Salah Mohamed Ali, Mustafa Mohammed Mustafa, Mohammed Osman Abdelaziz, Mohammed Elshiekh Saeed, Mohammed Ali Alzain
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