The Retrospective Evaluation of the Effects of the Delivery Time Intervals on the Newborn During Elective Cesarean Sections Under Spinal Anesthesia - Pages 12-16

Nejla Mendil Erdogan1, Berrin Gunaydin1, Asiye Ugras Dikmen2, Merih Bayram3 and Ebru Ergenekon4

1Gazi University School of Medicine, Department of Anesthesiology, Ankara, Turkey; 2Gazi University School of Medicine, Department of Public Health, Ankara, Turkey; 3Gazi University School of Medicine, Department of Gynecology and Obstetrics, Ankara, Turkey; 4Gazi University School of Medicine, Department of Pediatrics, Ankara, Turkey

DOI: http://dx.doi.org/10.14205/2309-4400.2013.01.01.3

Abstract:

Aim: We aimed to investigate whether delivery time intervals are related to newborn outcome by evaluating Apgar scores and umbilical cord blood results during elective cesarean section under spinal anesthesia.

Materials and Methods: Records of the 203 ASA I or ASA II pregnant women underwent elective cesarean section under spinal anesthesia during one-year period were evaluated retrospectively. Demographic properties of the parturients (age, weight, body mass index, gravidity, parity and gestational week) and newborns (birthweight and gender), and duration of surgery were presented. In order to demonstrate any possible relationship, time intervals from completion of spinal anesthesia (SA) to skin incision (SI), uterine incision (UI) and umbilical cord clamping (UCC) and from skin and uterine incisions to UCC, Apgar scores, umbilical artery and vein (UA and UV) blood gas analysis (UA-pH, UA-BE, UA-PO2, UA-PCO2, UV-pH, UV-BE, UV-PCO2 and UV-PO2) were also documented.

Results: There was a significant correlation between delivery time intervals including SA-SI, SA-UI and SA-UCC to UA-pH, UA-BE, UV-pH and UV-BE (p=0.0001). There was also a correlation between SI-UCC and UI-UCC to UV-pH (p=0.0001 and p=0.02) but not with UV-BE. No correlation was observed between SA-SI, SA-UI and SA-UCC to mean Apgar scores at 1 min. However, relatively significant correlation was observed between the time interval SA-SI to mean Apgar scores at 5 min (r=0.13, p=0.04).

Conclusion: We observed a strong correlation between the time intervals from SA to SI, UI, and UCC with the newborn outcome in terms of UV-pH and UV-BE. There was also a correlation between the time interval from SA to SI with Apgar score at 5 min. Therefore, prolongation of the delivery time interval particularly for parturients scheduled to undergo elective cesarean delivery under spinal anesthesia might possibly affect newborn outcome.

Keywords: Cesarean delivery, spinal anesthesia, Apgar score.