Document Detail


Non-urgent caesarean delivery increases the need for ventilation at birth in term newborn infants.
MedLine Citation:
PMID:  20584803     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the need for positive pressure ventilation (PPV) by bag and mask and by bag and endotracheal tube in newly born term infants with vertex presentation delivered by non-urgent caesarean section under regional anaesthesia or non-instrumental vaginal delivery. DESIGN: Cross-sectional study. SETTING: 35 public hospitals in 20 Brazilian state capitals. PATIENTS: 6929 inborn infants without congenital anomalies, with gestational ages from 37(0/7) to 41(6/7) weeks with vertex presentation, born between 1 and 30 September 2003. INTERVENTION: Non-urgent caesarean versus non-instrumental vaginal delivery. Non-urgent caesarean was defined as delivery occurring in the absence of prolapsed cord, third trimester haemorrhage, failure of labour induction, fetal distress or non-clear amniotic fluid. MAIN OUTCOME MEASURES: PPV with bag and mask and with bag and endotracheal tube. Both outcomes were adjusted for potential confounding variables by logistic regression analysis. RESULTS: 2087 infants were born by non-urgent caesarean and 4842 by non-instrumental vaginal delivery. Non-urgent caesarean delivery under regional anaesthesia compared to vaginal delivery under local or no anaesthesia increased the risk of bag and mask ventilation (OR 1.42, 95% CI 1.07 to 1.89) adjusted for number of gestations, maternal hypertension and birth weight. Ventilation with bag and endotracheal tube was associated only with low birth weight, adjusted for delivery mode and twin gestation. CONCLUSIONS: Term neonates with vertex presentation and clear amniotic fluid born by non-urgent caesarean section under regional anaesthesia need to be assisted at birth by health professionals skilled in PPV.
Authors:
Maria Fernanda Branco de Almeida; Ruth Guinsburg; José Orleans da Costa; Lêni Márcia Anchieta; Lincoln Marcelo Silveira Freire; Dioclécio Campos
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-06-28
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  95     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-18     Completed Date:  2010-10-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F326-30     Citation Subset:  AIM; IM    
Affiliation:
Neonatal Division, Federal University of São Paulo, São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anesthesia, Conduction / methods
Anesthesia, Obstetrical / methods
Birth Weight
Brazil
Cesarean Section*
Cross-Sectional Studies
Delivery, Obstetric / methods
Female
Humans
Infant, Low Birth Weight
Infant, Newborn
Intubation, Intratracheal / utilization
Perinatal Care / methods
Positive-Pressure Respiration / methods,  utilization*
Pregnancy
Young Adult

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


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