Effect of Spinal and General Anesthesia over Apgar score and blood PH of umbilical cord in Neonates Born after Elective Cesarean Section in Jenin governmental hospital
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Date
2018-09-25
Authors
Awwad, Mohammad
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Publisher
Mohammad Awwad
Abstract
Introduction: During pregnancy many physiological changes happens to prepare mother for labour and delivery, and developing of the fetous include renal vasodilatation, cardiac changes, renal plasma flow and glomerular filtration rate both increase. There is a rising in the number of woman underwent caesarean section, and this was noted in all over countries in the world. Different anesthetic method can be used to perform the C/S, as general or regional. The choice of anesthesia for cesarean section depends upon indication for operation, its urgency, or patients, obstetrician and anesthesiologist preferences.
Aim: To compare the effect of general anesthesia and spinal anesthesia on Apgar score and umbilical cord PH to newborns baby to patients undergoing elective C/S.
Material and methods: interventional study was used, to investigate which anesthesia type (spinal or general) have minimal or no effect over umbilical cord PH and Apgar score baby born after elective caesarian section. It was done in Jenin Governmental Hospital, in operation ward and recovery room. Randomization technique was used in this study. The sample size was (103) dividing in two groups 53 participants in G/A and 50 participants in spinal anesthesia. The following information was obtained from medical records for analysis: Demographic data , type of anesthesia ,obstetric factors gender, past medical history to mothers, past surgical history, newborn status, Apgar score to baby, Blood analysis PH: which taken from arterial cord blood. The neonatologist do assessment to baby, and researcher sent PH sample to analysis.
Result: Regarding result in the study showed that the average of Apgar score at one minute in G /A group was 7.4 ±.94, in spinal anesthesia was 8.3±1.01 (p< 0.001). The average of Apgar at minute 5 in General anesthesia group was 9.9±0.26, and in Spinal anesthesia was 9.9±0.44 (p=0.95). Umbilical artery blood PH of umbilical cord blood sample of newborns in general anesthesia group was acidosis or alkalosis 11.5% and 3.8% respectively ,while it was in spinal anesthesia group acidosis and alkalosis (2.1% and 0.0%) respectively.
Conclusion and recommendation: Spinal anesthesia is safer than general anesthesia, for both mother and fetus; it's associated with better neonatal out come as compared to general anesthesia. Apgar score and PH is a reliable predicator for neonate outcome. Umbilical cord arterial blood gases should be taken immediately after delivery from the umbilical cord to newborn has low Apgar score. One minute Apgar score in spinal anesthesia group was better and fetal acidosis was lower than general anesthesia group.
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Effect of Spinal and General Anesthesia over Apgar score and blood PH of umbilical cord in Neonates Born after Elective Cesarean Section in Jenin governmental hospital