Document Detail


Maternal and fetal catecholamines and uterine incision-to-delivery interval during elective cesarean.
MedLine Citation:
PMID:  2107478     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The fetal sympathoadrenal system is activated during periods of intrauterine stress such as inadequate uterine perfusion. During cesarean, the period of interruption of utero-placental blood flow is extended as the time interval from uterine incision to delivery increases. An increasing uterine incision-to-delivery interval with spinal or general anesthesia has been associated with a poorer neonatal outcome. This association has not been demonstrated previously in patients undergoing cesarean delivery under epidural anesthesia. We investigated the correlation between prolonged uterine incision-to-delivery intervals, fetal catecholamine concentrations, and fetal blood gas values at delivery in 25 parturients undergoing cesarean under epidural anesthesia and in 28 under spinal anesthesia. Infants delivered after prolonged uterine incision-to-delivery intervals had significantly lower pH values in both the epidural and spinal groups. With longer uterine incision-to-delivery intervals, umbilical arterial norepinephrine concentrations were increased significantly. Umbilical arterial pH values were significantly lower in infants with higher umbilical arterial catecholamine concentrations. The importance of minimizing the uterine incision-to-delivery interval, regardless of the type of anesthetic selected, is demonstrated.
Authors:
A M Bader; S Datta; G R Arthur; E Benvenuti; M Courtney; M Hauch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  75     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1990 Apr 
Date Detail:
Created Date:  1990-04-26     Completed Date:  1990-04-26     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  600-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Epidural
Anesthesia, Obstetrical
Anesthesia, Spinal
Carbon Dioxide / blood
Cesarean Section*
Epinephrine / blood*
Female
Fetal Blood / analysis*
Humans
Hydrogen-Ion Concentration
Norepinephrine / blood*
Oxygen / blood
Pregnancy
Time Factors
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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