Tonni G, Ferrari B, De Felice C, Ventura A
Division of Obstetrics and Gynaecology, Guastalla Civil Hospital - AUSL Reggio Emilia, Italy.
Int J Gynaecol Obstet. 2007 May;97(2):143-6. doi: 10.1016/j.ijgo.2006.11.021. Epub 2007 Feb 20.
To analyze the relation between fetal acid-base and neonatal status in an observational cohort study of 900 consecutive women with singleton pregnancies at term undergoing elective cesarean section.
The women were divided into 3 groups according to the type of anesthesia administered. Fetal acid-base status was assessed from umbilical cord blood (both artery and vein) and intermediate neonatal outcome was noted.
Epidural anesthesia was associated with the highest pH. The lowest pH and the highest pC0(2) values were associated with spinal anesthesia. Although maternal general anesthesia was associated with the highest values for partial pressure and saturation of oxygen in umbilical arterial blood, the newborns were more likely to be depressed than those born following spinal (P=0.0016) or epidural (P=0.0002) anesthesia.
If fetal oxygenation is the goal, general anesthesia provides the highest values for partial pressure and saturation of oxygen in umbilical arterial blood. However, epidural anesthesia was associated with better fetal and neonatal status than either spinal or general anesthesia.
在一项对900例足月单胎妊娠且接受择期剖宫产的连续孕妇进行的观察性队列研究中，分析胎儿酸碱状态与新生儿状况之间的关系。
根据所施行的麻醉类型将这些孕妇分为3组。通过脐血（动脉血和静脉血）评估胎儿酸碱状态，并记录新生儿的中期结局。
硬膜外麻醉与最高的pH值相关。最低的pH值和最高的pC0(2)值与脊髓麻醉相关。尽管母体全身麻醉与脐动脉血中氧分压和氧饱和度的最高值相关，但与脊髓麻醉（P = 0.0016）或硬膜外麻醉（P = 0.0002）后出生的新生儿相比，全身麻醉出生的新生儿更易出现抑制状态。
如果以胎儿氧合为目标，全身麻醉可使脐动脉血中的氧分压和氧饱和度达到最高值。然而，与脊髓麻醉或全身麻醉相比，硬膜外麻醉与更好的胎儿和新生儿状况相关。
