Apgar scores and cord blood gas values on neonates from cesarean with general anesthesia and spinal anesthesia

Abstract

Introduction: The incidence of cesarean section has increased in most countries in recent years. Anesthetic methods used during cesarean section have some advantages anddisadvantages to both mother and neonate. In this study, for comparison of general and spinalanesthesia we evaluated the short-term outcome of neonates born through cesarean section. Methods: Retrospectively, we studied 324 mothers undergoing cesarean section with generalor spinal anesthesia. Data were obtained including maternal age, gravidity, parity, and reason of cesarean section. Maternal systolic and diastolic blood pressure, neonatal Apgar score 1and 5th minutes, the biochemical status and blood gases of arterial samples withdrawn from thecord. Furthermore, we evaluated the relation between the maternal blood pressure changeswith neonatal Apgar score and the sample of cord pH (Power of Hydrogen). Results: Of 324 mothers undergoing cesarean section, 117 subjects (36.1%) had general and217 (63.9%) had spinal anesthesia. There were no statistical significant differences between the two groups regarding the demographic characteristic. The one minute Apgar score groupin the spinal anesthesia group was significantly higher than the general anesthesia group(P = 0.01). But there were no divergence between the two groups in five minute Apgar score.Mean fetal acidity in general anesthesia group was higher than the spinal anesthesia group, buttheir differences were not statistically significant. There were no statistical significantcorrelation between the maternal blood pressure and cord's arterial blood pH or neonatalApgar score. Conclusion: The one minute Apgar score in spinal anesthesia group was better and fetalacidosis was lower than the general anesthesia group, but there was not any significant difference between the two groups regarding systolic and diastolic pressure, and there was nosignificant correlation between the maternal mean blood pressure, Apgar score and pH ofarterial cord samples. Thus, possibility of maternal hypotension and decreased uteroplacentalperfusion should not prevent the use of spinal anesthesia for cesarean section.