A comparison of the effect of epidural, general, and no anesthesia on funic acid-base values by stage of labor and type of delivery.
The effect of epidural anesthesia on neonatal acid-base status, before, during, and after labor, was determined by review of funic blood-gas values from 142 women with normal term pregnancies and normal fetal heart rate patterns. Funic acid-base parameters were compared by type of anesthesia when stratified by mode of delivery (vaginal, cesarean section in the active phase of labor, or elective cesarean section). Use of epidural analgesia for vaginal delivery was associated with significantly longer labor, lower umbilical arterial pH, higher arterial PCO2 and arterial bicarbonate values. In women who had cesarean section in the active phase of labor, use of epidural anesthesia was associated with significantly lower arterial and venous PO2 values when compared with women who received general anesthesia. Patients who had elective cesarean section with epidural anesthesia had funic acid-base values similar to women who had general anesthesia. Epidural analgesia-anesthesia offers no clear advantage to the uncompromised term fetus.
Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63112.
J M
JM
Shyken
J S
JS
Smeltzer
L V
LV
Baxi
K J
KJ
Blakemore
S E
SE
Ambrose
R H
RH
Petrie
D000136:Acid-Base Equilibrium; D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D001784:Blood Gas Analysis; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000032:analysis*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007743:Labor, Obstetric; D011247:Pregnancy