RESUMEN
PURPOSE: The purpose of this study was to compare the obstetric and perinatal outcome between two groups with or without meconium staining of amniotic fluid (MSAF) at term birth in one-year consecutive population at our delivery unit. METHODS: Pregnancy complication including nonreassuring fetal heart rate pattern, intrauterine growth retardation, oligohydramnios, hydramnios and preeclampsia between the two groups were retrospectively documented by review of medical record. To evaluate the perinatal outcome, apgar score at 1min and 5min, and umbilical artery blood gas analysis were also analyzed. Student T test and chi square test were used for statistic analysis. RESULTS: The study population consisted of 687 full-term neonates with presence (n=89) and absence (n=598) of MSAF. Gestational age at delivery was significantly higher in the MSAF group (p12.0 mEq/L) was not increased. The incidence of non reassuring fetal heart rate pattern was also increased in the MSAF group (4.5% vs 1.0%, p=0.03). However there was no significant difference in 1 min and 5 min Apgar score. CONCLUSION: Although MSAF is associated with the risk of non reassuring fetal heart rate pattern and fetal acidemia, the metabolic acidemia and low apgar score at 5minutes was not significantly increased compared with clear amniotic fluid group. Delivery of pregnancy with MSAF should be managed under the careful fetal heart rate monitoring.
Asunto(s)
Femenino , Humanos , Recién Nacido , Embarazo , Líquido Amniótico , Puntaje de Apgar , Arterias , Análisis de los Gases de la Sangre , Retardo del Crecimiento Fetal , Edad Gestacional , Frecuencia Cardíaca Fetal , Concentración de Iones de Hidrógeno , Incidencia , Meconio , Registros Médicos , Oligohidramnios , Polihidramnios , Preeclampsia , Complicaciones del Embarazo , Estudios Retrospectivos , Nacimiento a Término , Arterias UmbilicalesRESUMEN
OBJECTIVE: The purpose of this study is to determine the effects of the methods of anesthesia on fetal acidemia following elective cesarean delivery among uncomplicated healthy parturients at term, with a single fetus and is to see the correlation of that results with maternal age, Apgar score. MATERIALS AND METHODS: The gestational age more than 37 weeks, singleton, estimated birth weight more than 2.5 kg with ultrasonographic profiles, 98 cases of uncomplicated parturients were included. Three methods of anesthesia - general, epidural, spinal - were chosen randomly. Umbilical artery blood samples just after delivery were obtained from a double clamped segment of cord using a 3 ml syringe that had been flushed with heparin, then transported in ice to the laboratory. RESULTS: There was no statistically significant difference between the three anesthesia groups in regarding to maternal age, birth weight, and Apgar score. The incidence of fetal acidemia was more prevalent in the epidural anesthesia group than the others, and less in the general anesthesia group. No clinically pathologic neonatal outcome was happened even one case of pathologic fetal acidemia among the spinal anesthesia group. The average PO2 of umbilical artery was 19.7 mmHg, and there was no statistically significant difference between the three anesthesia groups. The average PCO2 of umbilical artery was statistically high in the epidural anesthesia group. CONCLUSION: This study shows that the fetal acidemia can occur in three methods of anesthesia. Because there is no difference between the three methods of anesthesia with regarding to 1-minute, 5-minute Apgar scores and there is no specific finding for postpartum follow up of 1month. In conclusion, any method of anesthesia can be used safely in the view of neonatal outcome for elective cesarean delivery.
Asunto(s)
Anestesia , Anestesia Epidural , Anestesia General , Anestesia Raquidea , Puntaje de Apgar , Peso al Nacer , Feto , Estudios de Seguimiento , Edad Gestacional , Heparina , Hielo , Incidencia , Edad Materna , Periodo Posparto , Jeringas , Arterias UmbilicalesRESUMEN
OBJECTIVE: The purpose of this study is to determine the effects of the methods of anesthesia on fetal acidemia following elective cesarean delivery among uncomplicated healthy parturients at term, with a single fetus and is to see the correlation of that results with maternal age, Apgar score. MATERIALS AND METHODS: The gestational age more than 37 weeks, singleton, estimated birth weight more than 2.5 kg with ultrasonographic profiles, 98 cases of uncomplicated parturients were included. Three methods of anesthesia - general, epidural, spinal - were chosen randomly. Umbilical artery blood samples just after delivery were obtained from a double clamped segment of cord using a 3 ml syringe that had been flushed with heparin, then transported in ice to the laboratory. RESULTS: There was no statistically significant difference between the three anesthesia groups in regarding to maternal age, birth weight, and Apgar score. The incidence of fetal acidemia was more prevalent in the epidural anesthesia group than the others, and less in the general anesthesia group. No clinically pathologic neonatal outcome was happened even one case of pathologic fetal acidemia among the spinal anesthesia group. The average PO2 of umbilical artery was 19.7 mmHg, and there was no statistically significant difference between the three anesthesia groups. The average PCO2 of umbilical artery was statistically high in the epidural anesthesia group. CONCLUSION: This study shows that the fetal acidemia can occur in three methods of anesthesia. Because there is no difference between the three methods of anesthesia with regarding to 1-minute, 5-minute Apgar scores and there is no specific finding for postpartum follow up of 1month. In conclusion, any method of anesthesia can be used safely in the view of neonatal outcome for elective cesarean delivery.