Fetal acid-base and neonatal status after general and neuraxial anesthesia for elective cesarean section.
OBJECTIVE
To analyze the relation between fetal acid-base and neonatal status in an observational cohort study of 900 consecutive women with singleton pregnancies at term undergoing elective cesarean section.


METHODS
The women were divided into 3 groups according to the type of anesthesia administered. Fetal acid-base status was assessed from umbilical cord blood (both artery and vein) and intermediate neonatal outcome was noted.


RESULTS
Epidural anesthesia was associated with the highest pH. The lowest pH and the highest pC0(2) values were associated with spinal anesthesia. Although maternal general anesthesia was associated with the highest values for partial pressure and saturation of oxygen in umbilical arterial blood, the newborns were more likely to be depressed than those born following spinal (P=0.0016) or epidural (P=0.0002) anesthesia.


CONCLUSIONS
If fetal oxygenation is the goal, general anesthesia provides the highest values for partial pressure and saturation of oxygen in umbilical arterial blood. However, epidural anesthesia was associated with better fetal and neonatal status than either spinal or general anesthesia.
Tonni
G
G
Division of Obstetrics and Gynaecology, Guastalla Civil Hospital - AUSL Reggio Emilia, Italy. Tonni.Gabriele@ausl.re.it
Ferrari
B
B
De Felice
C
C
Ventura
A
A
D000136:Acid-Base Equilibrium / Q000187:drug effects*; D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000379:methods; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D001034:Apgar Score; D001784:Blood Gas Analysis; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood / Q000187:drug effects*; D005333:Fetus / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies