title: The impact of route of anesthesia on maternal and fetal ischemia modified albumin levels at cesarean section: a prospective randomized study.
abstract: OBJECTIVE
  Ischemia modified albumin has been shown to increase in ischemic situations, and has also been shown to increase in fetal cord blood in deliveries by cesarean section. The aim of this study is to reveal whether anesthesia has an impact on maternal and fetal cord ischemia modified albumin levels.
  
  
  METHODS
  Seventy two women with uncomplicated term pregnancies were randomized to spinal (n=37) or general anesthesia (n=35) groups. The blood pressure, oxygen saturation, and pulse rate of the patients were recorded during the procedure. Maternal blood samples of ischemia modified albumin (IMA) were taken 10 min from the start of the procedure. The fetal cord blood samples of IMA were taken immediately after birth.
  
  
  RESULTS
  Maternal (0.99 ± 0.19 vs. 0.80 ± 0.27) and fetal (1.00 ± 0.21 vs. 0.70 ± 0.26) IMA levels were significantly higher in the general anesthesia group. Fetal IMA levels were positively correlated with maternal gravidity (r=0.31; P=0.008), parity (r=0.25; P=0.028), and fetal birth weight (r=0.23, P=0.045). Also, as time from incision to delivery lengthens, fetal IMA levels increase (r=0.29, P=0.012).
  
  
  CONCLUSIONS
  Fetal cord ischemia modified albumin levels were higher in the general anesthesia group, therefore, it is proposed that regional anesthesia should be the preferred route of anesthesia for an elective cesarean section, at least until the impact of high fetal cord IMA levels are manifested.
authors.affiliation: Department of Obstetrics and Gynecology, Ufuk University School of Medicine, Ankara, Turkey. gamzesinem@hotmail.com
authors.forename: Gamze Sinem
authors.initials: GS
authors.lastname: Caglar
authors.forename: Perihan
authors.initials: P
authors.lastname: Erdogdu
authors.forename: Aslı Yarcı
authors.initials: AY
authors.lastname: Gursoy
authors.forename: Rabia
authors.initials: R
authors.lastname: Seker
authors.forename: Selda
authors.initials: S
authors.lastname: Demirtas
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000379:methods*; D000775:Anesthesia, Spinal / Q000009:adverse effects; D015415:Biomarkers / Q000378:metabolism; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007511:Ischemia / Q000097:blood / Q000209:etiology; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000209:etiology; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D000075462:Serum Albumin, Human; D055815:Young Adult
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; C561522:ischemia-modified albumin; D000075462:Serum Albumin, Human