Assessment of the Impact of Prolonged Cesarean Section on Neonatal Ph Publisher



Rahimisharbaf F¹ ; Golshahi F² ; Ataei H³ ; Shirazi M¹ ; Sahebdel B¹ ; Yousefi M⁴ ; Kaheh M⁵ ; Makhzani P¹ ; Momen A¹ ; Feizabad E¹ ; Gerayeli M¹
Source: Archives of Anesthesiology and Critical Care Published:2024

Abstract

Background: Prolonged predelivery time in cesarean-section (C-section) may be associated with worse neonatal outcomes such as lower umbilical cord acid-base profile. This study investigated the association between surgical and anesthetic predelivery time intervals and neonatal acidosis in pregnant women delivering via C-section under spinal anesthesia. Methods: This cross-sectional study was conducted on 70 pregnant women candidates for elective cesarean C-section, referred to Yas Hospital. Results: Umbilical artery pH<7.3 was observed in 27 (38.6%) out of 70 included participants. The study variables including maternal age, hypertension, and gestational diabetes were not associated with umbilical pH level. 1-minute Apgar scores were linearly associated with pH (β: 0.170, 0.100 to 0.239, p-value<0.001). Among all evaluated surgical and anesthetic intervals, induction of spinal anesthesia to delivery (β:-0.008,-0.012 to-0.004, p-value<0.001), and skin incision to uterine incision interval (β:-0.006,-0.009 to-0.002, p-value=0.002) interval time had a significant linear association with PH. Conclusion: The duration of induction of spinal anesthesia to delivery and skin incision to the uterine incision in non-emergent C-sections is linked to lower neonatal umbilical pH which shows the importance of optimizing the timing of elective C-section surgeries and reducing the risk of neonatal acidosis for obstetricians and anesthesiologists. © 2024 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.