Umbilical Cord Blood Parameters Research Articles

Does Monopolar Electrocautery Affect the Fetus during Cesarean Section?

Background and Objectives: This study aimed to assess the impact of monopolar electrocautery on the fetus during cesarean section. Materials and methods: A retrospective analysis was conducted with 552 patients delivered by cesarean section. Patients were grouped based on usage of monopolar electrocautery. In 272 patients, monopolar electrocautery was used to separate the tissues before the delivery. In 280 patients, no electrocautery was used. Newborn vital signs, Apgar scores, umbilical cord blood parameters, newborn serum parameters collected within 6th postpartum hour, and rate of newborn intensive care unit admission were compared. Results: The 1st and 5th minute Apgar scores were significantly higher in the electrocautery group; however, this difference lost its significance at the 10th minute. The median newborn pulse rate (148 (7) vs. 146 (6) beats per minute, p = 0.026), umbilical cord blood pH, and partial oxygen pressure were significantly higher in the electrocautery group compared to the no-electrocautery group (7.34 ± 0.06 vs. 7.31 ± 0.06, p < 0.001, and 25.5 (14.77) vs. 23 (16.08) mmHg, p = 0.025, respectively). The median umbilical cord blood serum calcium level was 1.51 (0.64) mmol/L in the electrocautery group, which was significantly lower than 1.9 (0.82) mmol/L in the no-electrocautery group (p = 0.002). The incidence of hypoglycemia was significantly lower in the electrocautery group than in the no-electrocautery group (2.2% vs. 5.7%, p = 0.035). Conclusions: Monopolar electrocautery during cesarean section affects the fetus, but it is safe to use it. Electrocautery is independently associated with umbilical cord blood pH and calcium level. Electrocautery may be associated with a lower incidence of hypoglycemia.

Correlation of cardiotocography with combined APGAR scores and diagnostic performance of umbilical cord parameters in predicting low combined APGAR scores – A prospective Cohort study

ObjectivesCombined Apgar score includes utilization of interventions such as Continuous positive airway pressure, Oxygen, Mask and Bag ventilation, I ntubation and ventilation, Ne onatal chest compression, Drugs, and newborn assessment. It has been proposed as a substitute for conventional Apgar score which is the gold standard for evaluating newborns right after birth but is impacted by medical interventions and preterm. Combined Apgar scores were examined to check for correlation with CTG tracing and umbilical cord blood parameters which gives an objective assessment of fetal hypoxia, in response to the demand for a more accurate tool for evaluating the neonate and to be used for medico-legal purposes. The study's objectives were to (1) determine the association of combined Apgar scores with suspicious and pathological CTG (2) the association of umbilical cord parameters with low combined Apgar scores and the diagnostic performance of these parameters in predicting low combined Apgar scores. Study designA prospective observational cohort study was conducted in a tertiary care center in East India. 2350 consecutive laboring mothers who had completed 34 weeks of gestation underwent cardiotocography according to institutional protocol and those with suspicious and pathological CTG who delivered within 1 h of abnormal CTG were recruited. Arterial blood was analyzed and the newborn was evaluated immediately after delivery with a combined Apgar scoring system ResultsOf the 2350 women, 50.7 % and 49.3 %, respectively, exhibited suspicious and abnormal CTG tracings. CTG was reported to have low diagnostic accuracy and specificity, with a sensitivity of 66.7 % and 88.9 %, respectively, in detecting combined Apgar at 1 and 5 min. The combined Apgar score at five minutes showed a strong association with acidosis. There was a statistically significant correlation between low combined Apgar and excess lactate and base at one and five minutes. With 100 % sensitivity and 95 % specificity, high lactate levels > 4.1 mM/L were found to predict newborn encephalopathy. ConclusionUmbilical cord blood parameters were found to be correlated with low combined Apgar scores. Combined Apgar scores may be a more useful tool for neonatal assessment and long-term morbidity of newborns. Additional research is required to determine whether it can take the role of conventional Apgar scores in clinical practice.

Effects of Dietary Lonicera flos and Sucutellaria baicalensis Mixed Extracts Supplementation on Reproductive Performance, Umbilical Cord Blood Parameters, Colostrum Ingredients and Immunoglobulin Contents of Late-Pregnant Sows.

The present study aimed to determine the effects of dietary Lonicera flos and Sucutellaria baicalensis mixed extract (LSE) supplementation during the late-pregnancy period on the reproductive performance, umbilical cord blood hematological parameters, umbilical cord serum biochemical parameters, immune indices, hormone levels, colostrum ingredients, and immunoglobulin contents of sows. A total of 40 hybrid pregnant sows were randomly assigned to the control group (CON; sows fed a basal diet) and LSE group (LSE; sows fed a basal diet supplemented with 500 g/t PE). The results indicated that dietary LSE supplementation significantly increased (p < 0.05) the number of alive and healthy piglets and the litter weight at birth, and significantly increased (p < 0.05) the platelet counts in umbilical cord blood. Dietary LSE supplementation significantly increased (p < 0.05) the levels of prolactin (PRL) and growth hormone (GH), and the content of interleukin 2 (IL-2) in umbilical cord serum. Moreover, immunoglobulin A (IgA) and immunoglobulin M (IgM) in the colostrum were increased with PE supplementation (p < 0.05). In conclusion, dietary LSE supplementation in late-pregnancy sows could improve reproductive performance and colostrum quality, and could also regulate the levels of reproductive hormone in umbilical cord serum.

Acid-base parameters of umbilical cord blood as evidence in a criminal trials.

Acid-base parameters of umbilical cord blood as evidence in a criminal trials.

Influence of Umbilical Cord Blood Biochemical Parameters and Disease Condition on the Expression of the TSG-6 Gene in Umbilical Mesenchymal Stem Cells.

BACKGROUND Mesenchymal stem cells (MSCs) are capable of secreting different substances, including the anti-inflammatory protein TSG-6, which can be useful in the treatment of diseases with inflammatory reactions. The main aim of this study was to evaluate the expression of the TSG-6 gene in MSCs derived from the umbilical cord. For better understanding of the anti-inflammatory properties of MSCs, we additionally assessed the expression of some interleukins (ILs). MATERIAL AND METHODS The study group included 45 patients after delivery, aged from 21 to 46 years; the average patient age was 33 years. MSCs were isolated enzymatically from umbilical cord Wharton's jelly, in vitro cultured, and characterized using flow cytometry; qPCR was performed to assess expression of the studied genes. The expression of genes of a number of pro-inflammatory ILs in MSCs was investigated in relation to the health of patients (coexistence of hypertension), the level of leukocytes, pCO2, and hemoglobin in the blood. RESULTS Our research showed that the expression of the TSG-6 gene in MSCs depends on coexisting diseases in the patient and the biochemical parameters of umbilical cord blood, including the important role of cord blood pH. We found that the levels of IL2 and IL6 expression were correlated with pCO2, and IL6 expression were correlated with pO2. CONCLUSIONS Our study suggests that maternal health status and cord blood biochemical parame-ters could affect the anti-inflammatory properties of MSCs; however, this needs to be confirmed in a future study.

Comparison of 2 anesthetic protocols and surgical timing during cesarean section on neonatal vitality and umbilical cord blood parameters

BackgroundThe objective of this study was to evaluate the relationship between the mode of anesthesia, the time form the induction to the extraction of a puppy and the immediate postnatal vitality and umbilical cord blood gases parameters in cesarean section derived-puppies. Two different anesthetic protocols were used: inhalation using isoflurane (ISO) and combined—inhalation and epidural (EPI) with propofol being the induction agent.ResultsSignificant differences were found in ISO group in pH values, pCO2 levels and Apgar scores between puppies at different extraction times (< 30 vs. ≥ 30 min). In ISO group puppies extracted later were more acidic (7.16 vs. 7.22), had higher levels of pCO2 (69 vs. 57 mmHg) and lower Apgar scores at birth (1.2 vs. 2.5). On the contrary, in EPI group no differences were observed between the delivery time, umbilical blood gas parameters and puppies’ vitality. Furthermore, the dams from the EPI group required lower concentrations of isoflurane (MAC 1.11 ± 0.19 vs.1.37 ± 0.16, p < 0.001).ConclusionsMultiple pregnancies frequent in dogs lead to significant differences in extraction times between the first and the last puppy during cesarean section. Obtained results showed that the mode of anesthesia and the surgical time would influence the neonatal outcome during cesarean section in dogs. The higher concentration of isoflurane with the longer time of exposure had a negative effect on the initial newborn vitality as well as the umbilical cord blood gas parameters. Therefore, when performing CS in giant dog breeds or expecting many puppies in the litter, it is worth considering epidural component that allow for lower concentrations of inhalant agents, which may contribute to a better clinical condition of newborns.

Reference intervals for complete blood count from Umbilical Cord Blood in newborns and comparison with Venous Blood Values.

Background and Objective:Umbilical cord blood which can be obtained by a non-invasive method can be informative about the clinical status of the newborn. It was aimed to establish reference intervals for umbilical cord blood parameters, and to compare complete blood count results between umbilical cord and venous blood samples in this study.Methods:This study was conducted at Medipol University Sefaköy Hospital, Department of Pediatrics, Istanbul, Turkey. A total of 1898 newborns who were born in a two-year period between January 2018 and December 2019 were included in the study. Venous blood samples were taken from 184 of them, and umbilical cord blood samples were taken from 1714 newborns.Results:The percentiles were determined according to gender and delivery method for the hematological parameters of umbilical cord blood. While mean platelet, eosinophil and mean corpuscular volume values were similar between the groups (p>0.05 for each), and significant differences were found between the groups in terms of all other mean hematological parameters (p<0.05 for each).Conclusion:The results of the complete blood count of umbilical cord blood samples can provide reliable information about the newborn. There are significant differences between umbilical cord and venous blood samples in terms of hematological parameters. For these reasons, it is necessary to determine reliable value ranges for umbilical cord blood hematological parameters in newborns. Data of our study can be a guide for further studies and clinicians.

Laboratory Characteristics of Umbilical Cord Blood in Makurdi North-Central Nigeria

Umbilical cord blood (UCB) which is useful in supportive and definitive management of inherited and acquired disorders is usually discarded in our environment. We sought to establish reference values for some haematological parameters of UCB in Makurdi, Nigeria to assist clinicians better interpret results of haematological parameters of UCB. This was a prospective quantitative study that involved analyzing UCB of qualified women to determine its complete blood count, fetal haemoglobin concentration, clotting profile and fibrinogen concentration. Reference ranges of these parameters were thereafter calculated using normal distribution method. The effects of maternal and fetal factors on these parameters were assessed using the Student t-test and ANOVA. The mean total white blood count (TWBC) was 12.3±3.7 x 109/L. Female births had significantly higher TWBC than male births (13.2 ± 3.3 x 109/L vs 11.0 ± 3.8 x 109/L, p=0.003). Babies that weighed 3.0-3.5kg also had significantly higher TWBC (18.9x109L) than those that weighed 2.4-2.9kg (8.7x109/L) p=0.010.Female births had significantly higher haemoglobin concentration (Hb) (13.9g/dl) than male births (11.9g/dl) p=0.001. Similarly, older women aged 32-41 years had significantly higher Hb (13.4g/dl) than those aged 18-24 years (11.6g/dl) p=0.002. Also, women that had more than two children had higher Hb than those who had one or two, (14.7g/dl vs 12.3g/dl) p=0.030. Babies that weighed 3.0-3.5kg at birth also had significantly higher Hb (16.2g/dl) than babies that weighed 2.4-2.9kg (12.3g/dl), p=0.003.The reference values of the haematological parameters of cord blood in our study were similar to what was reported from other developing countries. This study has provided data on haematological parameters of UCB for clinical use in our environment and we recommend routine UCB analysis in order to aid early detection of some inherited and congenital disorder.

Laboratory Characteristics of Umbilical Cord Blood in Makurdi North-Central Nigeria

Umbilical cord blood (UCB) which is useful in supportive and definitive management of inherited and acquired disorders is usually discarded in our environment. We sought to establish reference values for some haematological parameters of UCB in Makurdi, Nigeria to assist clinicians better interpret results of haematological parameters of UCB. This was a prospective quantitative study that involved analyzing UCB of qualified women to determine its complete blood count, fetal haemoglobin concentration, clotting profile and fibrinogen concentration. Reference ranges of these parameters were thereafter calculated using normal distribution method. The effects of maternal and fetal factors on these parameters were assessed using the Student t-test and ANOVA. The mean total white blood count (TWBC) was 12.3±3.7 x 109/L. Female births had significantly higher TWBC than male births (13.2 ± 3.3 x 109/L vs 11.0 ± 3.8 x 109/L, p=0.003). Babies that weighed 3.0-3.5kg also had significantly higher TWBC (18.9x109L) than those that weighed 2.4-2.9kg (8.7x109/L) p=0.010.Female births had significantly higher haemoglobin concentration (Hb) (13.9g/dl) than male births (11.9g/dl) p=0.001. Similarly, older women aged 32-41 years had significantly higher Hb (13.4g/dl) than those aged 18-24 years (11.6g/dl) p=0.002. Also, women that had more than two children had higher Hb than those who had one or two, (14.7g/dl vs 12.3g/dl) p=0.030. Babies that weighed 3.0-3.5kg at birth also had significantly higher Hb (16.2g/dl) than babies that weighed 2.4-2.9kg (12.3g/dl), p=0.003.The reference values of the haematological parameters of cord blood in our study were similar to what was reported from other developing countries. This study has provided data on haematological parameters of UCB for clinical use in our environment and we recommend routine UCB analysis in order to aid early detection of some inherited and congenital disorder.

Laboratory Characteristics of Umbilical Cord Blood in Makurdi North-Central Nigeria

Umbilical cord blood (UCB) which is useful in supportive and definitive management of inherited and acquired disorders is usually discarded in our environment. We sought to establish reference values for some haematological parameters of UCB in Makurdi, Nigeria to assist clinicians better interpret results of haematological parameters of UCB. This was a prospective quantitative study that involved analyzing UCB of qualified women to determine its complete blood count, fetal haemoglobin concentration, clotting profile and fibrinogen concentration. Reference ranges of these parameters were thereafter calculated using normal distribution method. The effects of maternal and fetal factors on these parameters were assessed using the Student t-test and ANOVA. The mean total white blood count (TWBC) was 12.3±3.7 x 109/L. Female births had significantly higher TWBC than male births (13.2 ± 3.3 x 109/L vs 11.0 ± 3.8 x 109/L, p=0.003). Babies that weighed 3.0-3.5kg also had significantly higher TWBC (18.9x109L) than those that weighed 2.4-2.9kg (8.7x109/L) p=0.010.Female births had significantly higher haemoglobin concentration (Hb) (13.9g/dl) than male births (11.9g/dl) p=0.001. Similarly, older women aged 32-41 years had significantly higher Hb (13.4g/dl) than those aged 18-24 years (11.6g/dl) p=0.002. Also, women that had more than two children had higher Hb than those who had one or two, (14.7g/dl vs 12.3g/dl) p=0.030. Babies that weighed 3.0-3.5kg at birth also had significantly higher Hb (16.2g/dl) than babies that weighed 2.4-2.9kg (12.3g/dl), p=0.003.The reference values of the haematological parameters of cord blood in our study were similar to what was reported from other developing countries. This study has provided data on haematological parameters of UCB for clinical use in our environment and we recommend routine UCB analysis in order to aid early detection of some inherited and congenital disorder.

Total Nucleated Cell Count and CD34+ Cell is Reduced in Preeclampsia and Gestational Diabetes Mellitus Pregnancies: Viable Affix Criteria for Cord Blood Banking

The aim of this study to determine the numbers of CD34+ cells and total nucleated cell (TNC) in umbilical cord blood (UCB) collected from pregnant mothers with gestational diabetes mellitus (GDM) and preeclampsia (PE), following statistical analysis of both maternal and perinatal factors which affect UCB parameters. Most of studies explored the influence of obstetric factors on the number of UCB cell collection and only a few looked at the effects on UCB haematopoietic stem cell (UCB-HSC) of common disorders complicating pregnancy. A total of 112 UCB samples (32 PE, 42 GDM and 38 non-diseased) were collected. CD34+ cell and NC count were enumerated using FACS Calibur. The TNC and CD34+ cells were significantly reduced in both PE and GDM groups as compared to the control group. The PE group shows significantly lower birth weight and higher BP which led to a lower UCB volume and CD34+ count. Gestational age shows significant correlation with nucleated cell count (NCC) and TNC. GDM group shows significantly lower systolic BP, NCC and TNC count, including low placental weight and birth weight. Conclusively, some obstetrics factors have significant influences to the numbers and quality of UCB-HSC in both PE and GDM groups, which could guide in the selection criteria for CB banking.

Correlation of placental microbiota with fetal macrosomia and clinical characteristics in mothers and newborns.

Substantial studies indicated that fetal macrosomia was associated with detrimental pregnancy outcomes, and increased susceptibility to metabolic diseases in later life. However, investigations into the association between placental microbiota and fetal macrosomia are limited. We aimed to profile the placental microbiota of fetal macrosomia and study whether they relate to clinical characteristics. Placenta samples were collected from fetal macrosomias and newborns with normal birth weight. The clinical characteristics, umbilical cord blood parameters were measured, and placental microbiota were sequenced and further analysed. The clinical characteristics of infants and mothers and umbilical cord blood parameters were significantly different between macrosomias and controls. The relative abundance of microbiota sequences revealed that microbial structures of the placenta differed significantly between macrosomia and controls. Regression analysis showed a cluster of key operational taxonomic unit (OTUs), phyla and genera were significantly correlated with body length, ponderal index and placenta weight, body weight increase during pregnancy of mothers, and cord blood IGF-1 and leptin concentrations. In conclusion, our study for the first time explored the relationship between placental microbiota profile and fetal macrosomia. It is novel in showing that a distinct placental microbiota profile is present in fetal macrosomia, and is associated with clinical characteristics of mothers and newborns.

Neonatal, placental, and umbilical cord blood parameters in pregnant women residing in areas with intensive pesticide application.

In rural populations, the proximity to areas with intensive pesticide application represents a risk factor of xenobiotic exposure. Here, we investigated whether newborns born to mothers residing in an area with intensive pesticide application show alterations in placental and neonatal morphometric standards, umbilical cord blood (UCB) biochemical parameters, and/or biomarkers related to oxidative stress and oxidative damage. Samples were collected from 151 healthy pregnant women residing in a rural area (rural group; RG) during the pesticide spraying (SS) and nonspraying (NSS) seasons, as well as from women from an urban population (control group; CG), and grouped according to the delivery type (vaginal or cesarean). In the vaginal delivery group, the placental weight and placental index were higher in the RG groups than in the CG (p=0.01), whereas in the cesarean delivery group, newborn weight was lower in the RG-SS group than in the CG. In the RG-SS group, UCB erythrocyte osmotic fragility and the DNA damage index (DI) were higher, and superoxide dismutase (SOD) activity was lower than in the RG-NSS group. Acetylcholinesterase and SOD activities were found to be inversely correlated with the DI.

Does the Type of Anesthesia for Caesarean Section Affect the Neonate? A Non- Randomized Observational Study Comparing Spinal versus General Anesthesia

The influences on neonates due to choice of anesthesia for cesarean section deliveries, general versus spinal were the focus of this prospective non randomized observational study. Aims and objectives: To study the effects of choice of obstetric anesthesia during Cesarean Section (General (GA) or spinal (SA): on mothers by assessing Mean arterial Blood pressure changes and Time to delivery from initiation of Anesthesia, & Uterine Incision: on neonates by assessing Apgar Scores and Umbilical cord blood parameters. Material and methods: Two groups of 20 expectant mothers each, posted for elective caesarean sections ASA 1 & 2. Group A: SA Group B: GA. Informed consent, IERB approval, Results: The two groups were comparable in terms of age, weight, pre-operative mean arterial pressure and gravid status. The mean speed of surgery in minutes was significantly faster under General Anesthesia (8.65 to 17.6) when measured from induction of anesthesia to delivery time, and (1.65 to 2.4) when measured from uterine incision to delivery time. The upper limit of block of spinal anesthesia was variable, but mostly centered around T4, T6. The maximum values of Fluctuations in the Blood pressure in the two groups showed that the SA group had a drop in the mean arterial pressure up to 54 mmHg, while the GA group showed a rise in the mean arterial pressure up to 107 mmHg. The neonatal cord blood parameters across the two groups showed no significant differences in pH, PCO2, HCO3, and base excess. However umbilical cord venous blood oxygenation (35.86) and Oxygen saturation (58.71) were significantly better when delivery was under GA in comparison with SA (26.59 and 44.58). Discussion: The benefits of a faster surgical time achieved under General anesthesia were not quantifiable as no difference in apgar score in the neonates of the two groups at 1 or 5 minute. The fluctuations in Blood pressure likewise did not translate to evidence of fetal hypoxia. The increased blood oxygenation as a consequence of controlled anesthesia was the only noteworthy finding in the cord blood analysis. Conclusion: There were no statistically significant changes on the apgar score of neonates or their blood biochemistry, if the choice of anesthesia for cesarean section were general or spinal. Cord blood oxygenation was higher with general anesthesia.

Comparison of Two Different Doses of Fentanyl Combined With Levobupivacaine For Elective Cesarean Section

Objectives: In this prospective, randomized, double-blind, controlled study, we compared the effects of two different doses of fentanyl (10 μg or 25 μg) given intrathecally in addition to 0.5% levobupivacaine for cesarean section. Methods: Eight hundred, ASA I-II parturients, who were scheduled for elective cesarean section, were enrolled in the study. They were randomly allocated into three groups. Group I received 0.5% levobupivacaine; Group II received 0.5% levobupivacaine plus 15 μg fentanyl; Group III received 0.5% levobupivacaine plus 25 μg fentanyl intrathecally. Ephedrine was administered as a bolus dose (0.1 mg/kg), and then the continuous infusion was initiated. The rate of infusion was maintained with respect to baseline systolic blood pressure until umbilical cord clamping. We recorded maternal sistolic blood pressure, heart rate, total ephedrine dose, fetal Apgar scores (at 1st and 5th min), and umbilical cord blood parameters. Other side effects, such as hypotension, nausea/vomiting, bradycardia, etc. were also noted. Results: Bolus, infusion and total ephedrine doses were significantly lower in Group III when compared with the other groups (P<0.05). The incidences of hypotension in the I, II, and III groups were 17.30%, 13.38%, and 11.63%, respectively. There was no significant difference between the three groups regarding the Apgar scores at the 1st or 5th min, umbilical arterial or venous pH. There was no difference in the incidence of other side effects among the three groups. Conclusion: We conclude that the addition of 25 μg fentanyl to adjusting the dose of levobupivacaine to a patient's height decreases the ephedrine requirement without additional side effects and adverse neonatal outcomes when compared with the other groups. The levobupivacaine doses as determined by the length of the patients’ and the use of the appropriate fluid resuscitation therapy with an infusion of ephedrine can be used effective methods.

Biological Reference Interval for Hematological Profile of Umbilical Cord Blood: A Study Conducted at A Tertiary Care Centre in South India.

Umbilical cord blood (UCB) a source of hematopoietic stem cells, is also an acceptable sample to assess neonatal sepsis. Though reports are available for stem cell counts very minimal literature is available regarding hematologic parameters, which may vary on ethnicity. To establish biological reference interval for hematological parameters of umbilical cord blood to guide neonatologists, hematopoietic stem cell transplant specialists and future analysis. Prospective longitudinal study was done from January 2014 to April 2014 after ethics committee approval. UCB from 120 full term new borns of normal birth weight born out of uneventful pregnancy to mothers aged between 21 to 45 years with hemoglobin above 10g/dL were processed in Beckman Coulter LH780 analyzer for complete blood count and counter checked by peripheral smear. Results tabulated in Microsoft excel are analyzed using IBM SPSS statistics 16 software. Male to female ratio is 1:1.05. There is no difference in the values between males and females. When compared with few studies available, though many values are comparable a few values are not comparable. This study can be a useful guide to neonatologists, hematopoietic stem cells transplant hematologists and future analysis.

Efedrina frente a fenilefrina en bolo e infusión continua para prevención de la hipotensión arterial secundaria a la anestesia subaracnoidea en cesáreas. Estudio prospectivo, aleatorizado

ObjectiveSubarachnoid spinal anesthesia for cesarean section is associated with a high incidence of hypotension, which can require the use of vasoconstrictors. The aim of this trial was to compare ephedrine to phenylephrine for the prevention of secondary hypotension and to assess the adverse effects on both mother and newborn. Material and methodsEighty patients undergoing elective or emergency cesarean section, in the absence of uterine activity or fetal risk, were randomized to receive prophylaxis with ephedrine or phenylephrine immediately after the spinal block. Patients in the ephedrine group received an intravenous bolus of 0.1 mg/kg plus continuous infusion at a rate of 0.5 mg/kg/h; patients in the phenylephrine group received an intravenous bolus of 1.5 µg/kg plus a continuous infusion at 1.5 µg/kg/min. Infusion was maintained until umbilical cord clamping. We recorded maternal blood pressure, heart rate, nausea and vomiting, dizziness, bradycardia, hypotension, hypertension, fetal Apgar index, and umbilical cord blood parameters (pH, PCO2, and HCO3). ResultsThe overall incidence of hypotension was 11.2%, with no significant between-group differences (ephedrine group, 11.4%; phenylephrine group, 11.1%). The incidences of hypertension and bradycardia were higher in the phenylephrine group (27.8% and 2.3%, respectively) than in the ephedrine group (25% and 0%, respectively). Umbilical cord blood parameters and Apgar scores were similar. After suspension of continuous infusion, an episode of hypotension was detected in 22.5% of the patients (72.2% of these patients were in the phenylephrine group and 27.8% were in the ephedrine group). ConclusionsAt the doses of ephedrine and phenylephrine administered in this trial, the ability of these drugs to prevent hypotension during cesarean section proved to be similar. Higher incidences of adverse events (hypertension and bradycardia) were observed in the phenylephrine group. No differences were observed in neonatal effects.