RESUMEN
Cesarean section (CS) is an important challenge for a pregnant woman and her newborn. The most common anesthesia techniques used for CS are general anesthesia (GA) and spinal anesthesia (SA). This study was designed to compare the modulation of genes whose expression level is indicative of the immune system following exposure to GA and SA. The present study was performed on 40 women who were scheduled for elective CS receiving GA or SA. The expression levels of the relative mRNA of Interleukin (IL)-4, IL-6, IL-10, IL-17, Interferon (IFN)-γ, and tumor growth factor (TGF)-ß before anesthesia (T0) and 24 hours post-anesthesia (T1) were analyzed by real-time polymerase chain reaction (RT-PCR) technique. Twenty-four hours post-anesthesia, the expression levels of IL-10, IL-17, and IFN-γ genes were decreased while the expressions of IL-4, IL-6, and TGF-ß genes were upregulated in two groups, however, the differences were not significant. The mRNA level of IL-4 was increased in the SA group significantly. The post-CS mRNA levels of IL-4 in the SA group may indicate that SA is more appropriate than GA for the initiation of tissue repair pathways.
Asunto(s)
Anestésicos/uso terapéutico , Citocinas/genética , Expresión Génica/efectos de los fármacos , Adulto , Cesárea/métodos , Femenino , Expresión Génica/genética , Humanos , Interleucina-10/genética , Interleucina-4/genética , Embarazo , ARN Mensajero/genética , Factor de Crecimiento Transformador beta/genética , Factor de Necrosis Tumoral alfa/genética , Adulto JovenRESUMEN
Due to advances in surgical procedure, anesthesia techniques, blood transfusion and antibiotic therapy, the technique of cesarean section has been progressing over the time. However, cesarean section is still a risk-specific operation, with long-term and shortterm consequences for the mother and neonate. The rate of cesarean surgery is constantly growing due to both justifiable and nonjustifiable medical and non-medical reasons. There is evidence indicating that efforts are made in many countries to reduce the rate of cesarean delivery. In this review article, we try to assess the frequency of cesarean section in different countries, especially Iran. We searched several keywords, including cesarean section prevalence, cesarean section rate, world, delivery, Iran and health policies within the newest articles published in Google Scholar, PubMed, and ISI/Web of Sciences, as well as Iranian databases (Magiran, SID), from January 2017 to April 2019. The results show that there is still a high prevalence of C-section. In Iran, the highest rate of cesarean was in Tehran province (62.1%-72.1%) and the lowest was in Sistan and Baluchestan province (12%). It appears necessary to plan for effective interventions in terms of painless vaginal delivery, improving the quality of vaginal delivery services, proper culture and education.
