| Autor: |
BADER, ANGELA M., DATTA, SANJAY, ARTHUR, G RICHARD, BENVENUTI, ERIC, COURTNEY, MARY, HAUCH, MARTHA |
| Zdroj: |
Obstetrics & Gynecology (Ovid); April 1990, Vol. 75 Issue: 4 p600-603, 4p |
| Abstrakt: |
The fetal sympathoadrenal system is activated during periods of intrauterine stress such as inadequate uterine perfusion. During cesarean, the period of interruption of uteroplacental blood flow is extended as the time interval uterine incision to delivery increases. An increasing uterine incision-to-delivery interval with spinal or general anesthesia has been associated with a poorer neonatal outcome. This association has not been demonstrated previously in patients undergoing cesarean delivery under epidural anesthesia. We investigated the correlation between prolonged uterine incision-to-delivery intervals, fetal catecholamine concentrations, and fetal blood gas values at delivery in parturients undergoing cesarean under epidural anesthesia and in 28 under spinal anesthesia. Infants delivered after prolonged uterine incision-to-delivery intervals had significantly lower pH values in both the epidural and spinal groups. With longer uterine incision-to-delivery intervals, umbilical arterial norepinephrine concentrations were increased significantly. Umbilical arterial pH values were significantly lower in infants with higher umbilical arterial catecholamine concentrations. The importance of minimizing the uterine incision-to-delivery interval, regardless the type of anesthetic selected, is demonstrated. (Obstet Gynecol 75600, 1990) |
| Databáze: |
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