Effect of anaesthetic technique on neonatal morbidity in emergency caesarean section for foetal distress.

BACKGROUND:While foetal distress is typically associated with ischaemic injury, few studies have assessed neonatal morbidity for emergency caesarean section. Moreover, the decision of the anaesthetic technique may be of paramount importance in emergency caesareans, because of the limited time and in...

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Main Authors: Ipek Saadet Edipoglu, Fatma Celik, Elif Cirakoglu Marangoz, Gulin Haroglu Orcan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC6239306?pdf=render
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spelling doaj-cdb72bd5fb0440c3b43cf5c8043b12a42020-11-24T21:32:48ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011311e020738810.1371/journal.pone.0207388Effect of anaesthetic technique on neonatal morbidity in emergency caesarean section for foetal distress.Ipek Saadet EdipogluFatma CelikElif Cirakoglu MarangozGulin Haroglu OrcanBACKGROUND:While foetal distress is typically associated with ischaemic injury, few studies have assessed neonatal morbidity for emergency caesarean section. Moreover, the decision of the anaesthetic technique may be of paramount importance in emergency caesareans, because of the limited time and increased risk. We aimed to evaluate the effect of the anaesthetic technique on neonatal morbidity in emergency caesarean indicated for foetal distress. METHODS:This was a single-centre, prospective observational study, conducted between July-2015 and December-2015. The study enrolled parturient with indication for emergency caesarean section after diagnosis of foetal distress, who received either regional or general anaesthesia. The outcome measures were: 1, 5-minute Apgar scores; umbilical blood pH; length of hospitalization; and morbidity, defined as a 5-minute Apgar score <7, need for mechanical ventilation, admittance to a neonatal intensive care unit, or respiratory insufficiency symptoms. RESULTS:61 patients were included in the study, of whom 31 received regional anaesthesia. Neonatal morbidity was noted in 5 and 9 cases with regional and general anaesthesia, respectively. The 1-minute Apgar score was significantly lower(p = 0,045) for cases with general anaesthesia, which was not true for the 5-minute Apgar score. Regional anaesthesia was non-significantly associated with shorter length of hospitalization, lower incidence of morbidity, and higher umbilical blood pH. When we take regional anaesthesia cases as a reference point, we detected that general anaesthesia cases are showing 2,2 times more morbidity risk. But these results did not reach any statistically significant levels. CONCLUSIONS:While we did find some improved results for regional anaesthesia group, we found no statistical evidence that neither anaesthesia technique is superior regarding neonatal morbidity. We think that regional anaesthesia should be preferred whenever possible because of our improved results of length of hospital stay, APGAR and morbidity and we think that general anaesthesia is indicated for very urgent cases or regional anaesthesia contraindicated patients. TRIAL REGISTRATION:http://www.isrctn.com/ISRCTN15181117.http://europepmc.org/articles/PMC6239306?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Ipek Saadet Edipoglu
Fatma Celik
Elif Cirakoglu Marangoz
Gulin Haroglu Orcan
spellingShingle Ipek Saadet Edipoglu
Fatma Celik
Elif Cirakoglu Marangoz
Gulin Haroglu Orcan
Effect of anaesthetic technique on neonatal morbidity in emergency caesarean section for foetal distress.
PLoS ONE
author_facet Ipek Saadet Edipoglu
Fatma Celik
Elif Cirakoglu Marangoz
Gulin Haroglu Orcan
author_sort Ipek Saadet Edipoglu
title Effect of anaesthetic technique on neonatal morbidity in emergency caesarean section for foetal distress.
title_short Effect of anaesthetic technique on neonatal morbidity in emergency caesarean section for foetal distress.
title_full Effect of anaesthetic technique on neonatal morbidity in emergency caesarean section for foetal distress.
title_fullStr Effect of anaesthetic technique on neonatal morbidity in emergency caesarean section for foetal distress.
title_full_unstemmed Effect of anaesthetic technique on neonatal morbidity in emergency caesarean section for foetal distress.
title_sort effect of anaesthetic technique on neonatal morbidity in emergency caesarean section for foetal distress.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2018-01-01
description BACKGROUND:While foetal distress is typically associated with ischaemic injury, few studies have assessed neonatal morbidity for emergency caesarean section. Moreover, the decision of the anaesthetic technique may be of paramount importance in emergency caesareans, because of the limited time and increased risk. We aimed to evaluate the effect of the anaesthetic technique on neonatal morbidity in emergency caesarean indicated for foetal distress. METHODS:This was a single-centre, prospective observational study, conducted between July-2015 and December-2015. The study enrolled parturient with indication for emergency caesarean section after diagnosis of foetal distress, who received either regional or general anaesthesia. The outcome measures were: 1, 5-minute Apgar scores; umbilical blood pH; length of hospitalization; and morbidity, defined as a 5-minute Apgar score <7, need for mechanical ventilation, admittance to a neonatal intensive care unit, or respiratory insufficiency symptoms. RESULTS:61 patients were included in the study, of whom 31 received regional anaesthesia. Neonatal morbidity was noted in 5 and 9 cases with regional and general anaesthesia, respectively. The 1-minute Apgar score was significantly lower(p = 0,045) for cases with general anaesthesia, which was not true for the 5-minute Apgar score. Regional anaesthesia was non-significantly associated with shorter length of hospitalization, lower incidence of morbidity, and higher umbilical blood pH. When we take regional anaesthesia cases as a reference point, we detected that general anaesthesia cases are showing 2,2 times more morbidity risk. But these results did not reach any statistically significant levels. CONCLUSIONS:While we did find some improved results for regional anaesthesia group, we found no statistical evidence that neither anaesthesia technique is superior regarding neonatal morbidity. We think that regional anaesthesia should be preferred whenever possible because of our improved results of length of hospital stay, APGAR and morbidity and we think that general anaesthesia is indicated for very urgent cases or regional anaesthesia contraindicated patients. TRIAL REGISTRATION:http://www.isrctn.com/ISRCTN15181117.
url http://europepmc.org/articles/PMC6239306?pdf=render
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