Do all deliveries with elective caesarean section need paediatrician attendance?
OBJECTIVE
To determine whether paediatrician attendance to deliveries with elective caesarean section (CS) is really needed for term and also for preterm babies with 35-37 weeks gestational age.


METHODS
Singleton newborns ≥35 gestational weeks without any identified risk factor were evaluated for resuscitation steps prospectively after CS under regional and general anaesthesia.


RESULTS
545 infants were included in the study. 150 (27.5%) of infants needed only supplemental oxygen and 23 (4.2%) neonates needed bag and mask ventilation. None of the babies needed cardiopulmonary resuscitation (CPR) (chest compression) or endotracheal tube insertion/epinephrine administration. More infants required supplemental oxygen and bag-mask ventilation in general anaesthesia delivery group compared to spinal/epidural anaesthesia group (35.5% vs. 24.4%, p = 0.29 for oxygen and 9.2 % vs. 2.3%, p < 0.0001 for bag-mask) The need for resuscitation steps was not statistically significantly different between neonates who were born in 35-37 gestational week and neonates who were born ≥38 week (p = 0.170 for supplementary oxygen, p = 0.442 for bag-mask ventilation).


CONCLUSIONS
There is not increased risk for chest compression and entubation for infants ≥ 35 gestation weeks without antenatally identified risk factors born with elective CS either under regional or general anesthesia and only 4.2% of the babies needed bag-mask ventilation, so a health care personel who knows basic NRP may be sufficient in the clinics where it is easy to achieve an advanced skilled health care personel when needed.
Department of Paediatrics, Division of Neonatology, Çukurova University, Faculty of Medicine, Adana, Turkey. fozlu@cu.edu.tr
Ferda
F
Ozlu
Hacer
H
Yapıcıoglu
Bahriye
B
Ulu
Selim
S
Buyukkurt
Hakkı
H
Unlugenc
D000773:Anesthesia, Obstetrical / Q000379:methods / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D003696:Delivery Rooms / Q000458:organization & administration; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D020380:Needs Assessment; D010372:Pediatrics; D010819:Physician's Role; D011247:Pregnancy; D012151:Resuscitation / Q000706:statistics & numerical data; D000078329:Workforce