A Comparison Study of Fetal Acidemia in Relation to Anesthesia Method Following Elective Cesarean Delivery

Lee, Jeong Hun; Lee, Ho; Koh, Seon Hwan; Jung, Hoe Ryoun; Kim, Sang Hoon; Lee, Ji Young; Song, Eun Seop; Koh, Seung Kwon; Yim, Moon Hwan; Lee, Woo Young

Abstract

OBJECTIVE
The purpose of this study is to determine the effects of the methods of anesthesia on fetal acidemia following elective cesarean delivery among uncomplicated healthy parturients at term, with a single fetus and is to see the correlation of that results with maternal age, Apgar score.
MATERIALS AND METHODS
The gestational age more than 37 weeks, singleton, estimated birth weight more than 2.5 kg with ultrasonographic profiles, 98 cases of uncomplicated parturients were included. Three methods of anesthesia - general, epidural, spinal - were chosen randomly. Umbilical artery blood samples just after delivery were obtained from a double clamped segment of cord using a 3 ml syringe that had been flushed with heparin, then transported in ice to the laboratory.
RESULTS
There was no statistically significant difference between the three anesthesia groups in regarding to maternal age, birth weight, and Apgar score. The incidence of fetal acidemia was more prevalent in the epidural anesthesia group than the others, and less in the general anesthesia group. No clinically pathologic neonatal outcome was happened even one case of pathologic fetal acidemia among the spinal anesthesia group. The average PO2 of umbilical artery was 19.7 mmHg, and there was no statistically significant difference between the three anesthesia groups. The average PCO2 of umbilical artery was statistically high in the epidural anesthesia group.
CONCLUSION
This study shows that the fetal acidemia can occur in three methods of anesthesia. Because there is no difference between the three methods of anesthesia with regarding to 1-minute, 5-minute Apgar scores and there is no specific finding for postpartum follow up of 1month. In conclusion, any method of anesthesia can be used safely in the view of neonatal outcome for elective cesarean delivery.