effect of mode of delivery and types of anaesthesia on fetal welfare

ABSTRACT

This study was carried out on 60 non complicated healthy full term pregnant females and their neonates to study the effect of the mode of delivery and types of anaesthesia [general or epidural] on fetal welfare. The were divided into 4 equal groups, group I [natural vaginal delivery], group II [vaginal delivery under epidural anaesthesia, group III [elective cesarean section under general anaesthesia] and group IV [elective cesarean section under epidural anaesthesia]. For all of them, the plasma catecholamines and cortisol levels were measured. In groups I and II, the first sample was taken at 4-6 cm cervical dilatation and the second at the time of delivery of the head, while in groups III and IV, the first sample was taken just before induction of anaesthesia and the second sample at the time of uterine incision. Arterial blood gases for all parturients were done at the time of delivery of the head in groups I and II and at the time of uterin incision in groups III and IV. Fetal arterial samples were taken from the umbilical cord for all neonates for measurement of plasma catecholamines, cortisol and blood gases. Also, APGAR score at 1 and 5 min, was recorded. The of this study showed that the maternal catecholamines and cortisol levels increased significantly in group 1 and III while they decreased significantly in group II and group IV. The fetal catecholamines and cortisol increased significantly in groups I and II when compared with groups III and IV, also it increased significantly in group IV when compared with group III. The results of this study showed that the fetal outcome were similar in the 4 studied groups as judged by APGAR score and blood gases analysis. So, the conclusion of this study is that epidural anaesthesia during vaginal delivery or cesarean section may be of value for fetal welfare