Assessment of the Impact of Prolonged Cesarean Section on Neonatal PH

Fatemeh Rahimi-Sharbaf; Fatemeh Golshahi; Hosseinali Ataei; Mahbobeh Shirazi; Behrokh Sahebdel; Maryam Yousefi; Majid Kaheh; Parestesh Makhzani; Akhtar Momen; Elham Feizabad; Maryam Gerayeli

doi:10.18502/aacc.v10i3.15696

Fatemeh Rahimi-Sharbaf Department of Perinatology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Fatemeh Golshahi Maternal, Fetal and Neonatal Research Center, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Hosseinali Ataei Department of Anesthesiology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mahbobeh Shirazi Department of Perinatology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Behrokh Sahebdel Department of Perinatology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Maryam Yousefi Department of Obstetrics and Gynecology, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
Majid Kaheh Department of Internal Medicine, School of Medicine, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Parestesh Makhzani Department of Perinatology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Akhtar Momen Department of Perinatology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Elham Feizabad Department of Perinatology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Maryam Gerayeli Department of Perinatology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10i3.15696

Keywords: Cesarean Section; Anesthesia; Spinal; Infant; Newborn; Fatal outcome

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.