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KMID : 0378019900330040051
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New Medical Journal
1990 Volume.33 No. 4 p.51 ~ p.58
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Maternal and Fetal Catecholamine Levels at Elective Casarean Section under Grneral or Epidural Anesthesia Versus at Vaginal Delivery
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Abstract
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Maternal and fetal plasma levels of catecholarnines were measured in 15 cesarean section cases under general or epidural anesthesia, and 5 vaginal deliveries.
Maternal venous levels of norepinephrine showed marked increase in vaginal delivery cases (493.1±57.4 pg / ml) but in cesarean section cases under general anesthesia, they showed a little decrease (231.3+32.2 pg / ml). and in epidural andesthesia cases, they showed marked decrease (184.3+17.2 pg/ml).
The mean level of epinephrine in maternal plasma were 245.7+28.8 pg / ml at vaginal delivery, 130.3+27.7 pg / ml at cesarean section under general anesthesia. and 89.84 10.2 pg / ml at cesarean section under epidural anesthesia.
The highest levels were found at the vaginal delivery, and the lowest one at the epidural anesthesia.
Fetal outcomes were similar in all three groups (vaginal delivery, cesarean section under general anesthesia and under epidural anesthesia), as judged by Apgar score and fetal heart rates. However, neanates delivered vaginally demonstrated a markedly higher sympathoadrenal activation, showing norepinephrine 4036+566.5 pg / ml, and epinephrine 2061±393.5 pg / ml. and those born by cearean section under epidural anesthesia(norepinephrine 2763.9+206.5 pg / ml, and epinephrine 1863.3±84.4 pg / ml), and those born under general anesthesia(norepinephrine 1667.3+316.5 pg / ml and epinephrine 780.3+83.3 pg / ml).
These results may have a clinical relevance, since fetal sympathoadrenal activation is thought to promote extrauterine adaptation.
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