Various factors; i.e., maternal and fetal conditions, method of ansthesia, induction -delivery time (IDT), induction -uterine incision time (IUT), uterine incision - delivery time (UDT), surgical experience (specialists vs. residents), and
gestational
age; which might influence neonatal outcome following cesarean section were investigated in sixty-one patients who underwent cesarean section at Han Yang University Hospital between August 1992 and March 1993. Neonatal outcome was assessed by 1-
and
5-minute Apgar scores, and umbilical vein blood gas analysis (UVBGA) taken immediately after birth.
@ES The results were as follows.
@EN 1) Preoperative maternal conditions did not affect neonatal outcome. For the neonates of normal and abnormal maternal conditions, the 1-minute Apgar score were 7.2±1.0 and 6.8±1.0, respectively. In the same groups of neonates, the UVBGA
showed pHa
7.33±0.04 and 7.33±0.05; PaCO2 44.7±5.1 and 44.4±7.4 mmHg; PaO2 30.5±7.1 and 27.9±6.3 mmHg; and BE -2.7±3.5 and -3.8±3.5 mEq/L, respectively.
2) Method of anesthesia did not change neonatal outcome. In the general and epidural anestheia groups, the 1- minute Apgar scores were 7.1±1.0 and 7.3±0.8, respectively. The UVBGA in the same groups showed pHa 7.33±0.05, 7.34±0.03, PaCO2
44.6±6.1,
41.0±6.1 mmHg; PaO2 29.5±6.8, 28.7±6.6 mmHg; and BE -3.2±3.5, -4.0±3.6 mEq/L, respectively.
3) IDT did not influence neonatal outcome. In the groups with IDT exceeding or equal to 10 minutes and less than 10 minutes, the 1-minute Apgar scores were 7.2±1.0 and 7.0±1.0 with Idt, respectively. In the same groups, the UVBGA revealed pha
7.33±0.04, 7.33±0.05; PaCO2 40.0±6.2, 44,9±6.1 mmHg; PaO2 28.8±7.1 mmHg; and BE -2.8±3.5, -3.8±3.5 mEq/L, respectively. IDT was more than 10 minutes in all epidural anesthesia cases.
4) In the groups with UGU more than or equal to 3 minutes and less than 3 minutes, the 1minute Apgar scores were 7.0±1.1 and 6.7±1.6, respectively. In the same groups, the UVBGA revealed pHa 7.32±0.05, 7.33±0.05; PaCO2 41.8±5.1, 44,4±6.4
mmHg;
PaO2 28.3±6.2, 29.5±6.9 mmHg; and BE -3.9±3.6, -5.0±2.8 mEq/L, respectiveiy.
5) Surgical experience did not contribute to the neonatal outcome. The 1-minute Apgar scores were 7.2±1.0 and 7.0±1.1 in the groups where cesarean section were performed by specialists and residents, respectively. UVBGA showed PHa 7.33±0.04,
7.32±0.06; PaCO2 44.8±6.5, 44.3±5.8 mmHg; PaO2 30.2±6.9, 28.56.9 mmHg; and Be -2.6±3.4, -3.9±3.6 mEq/L, respectively in the same groups.
6) Gestational age, determined as fullterm or preterm, did not influence neonatal outcome. In the fullterm and preterm neonates, the 1-minute Apgar scores were 7.1±1.0 and 6.6±1.1, respectively. UVBGA showed pH2 7.33±0.05, 7.32±0.05; PaCO2
44.5±6.3, 45.0±4.9 mmhg; PaO2 29.4±6.9, 30.0±6.6 mmHg; and BE -3.2±3.6, -2.7±2.1 mEq/L, respectivly.
It appears that maternal and fetal conditions, method of anesthesia, IDT and UDT, experience of surgery, and gestational age do not influence post-cesarean neonatal outcome.
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