The effect of time intervals on neonatal outcome in elective cesarean delivery at term under regional anesthesia.
OBJECTIVE
To measure 3 intervals of time-induction of regional anesthesia to delivery (I-D), initial skin incision to delivery (S-D), and uterine incision to delivery (U-D)-in elective cesareans and to evaluate the impact of the duration of these 3 components on short-term neonatal outcome.


METHODS
We reviewed retrospective data on the duration of the components from the computerized database of the obstetrics operation room at the Sheba Medical Center, Tel Aviv, Israel, and from the medical records of term neonates.


RESULTS
Sufficient data were available in 933 cases. The parameters associated with longer time to delivery at any stage were epidural rather than spinal anesthesia, maternal diabetes, previous cesarean delivery, antihypertensive treatment, higher birth weight (3456 g and 3285 g for U-D interval longer than 2 minutes and U-D interval up to 2 minutes, respectively; P=0.02), and male fetus. The duration of the I-D, S-D, and U-D intervals had no significant impact on any of the measured neonatal parameters.


CONCLUSIONS
With regard to neonatal wellbeing, obstetricians have a relatively large safety margin in the time taken for inducing regional anesthesia and making the first and uterine incisions.
Maayan-Metzger
Ayala
A
Department of Neonatology, Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. maayan@post.tau.ac.il
Schushan-Eisen
Irit
I
Todris
Liat
L
Etchin
Abba
A
Kuint
Jacob
J
D000328:Adult; D000765:Anesthesia, Conduction / Q000706:statistics & numerical data*; D000767:Anesthesia, Epidural / Q000706:statistics & numerical data; D000775:Anesthesia, Spinal / Q000706:statistics & numerical data; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007557:Israel; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D047929:Term Birth; D055815:Young Adult
D000959:Antihypertensive Agents