Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, 33343 Mersin, Turkey.
Department of Neonatology, Mersin University Faculty of Medicine, 33343 Mersin, Turkey.
Medicina (Kaunas). 2024 Sep 5;60(9):1453. doi: 10.3390/medicina60091453.
This study aimed to assess the impact of monopolar electrocautery on the fetus during cesarean section. A retrospective analysis was conducted with 552 patients delivered by cesarean section. Patients were grouped based on usage of monopolar electrocautery. In 272 patients, monopolar electrocautery was used to separate the tissues before the delivery. In 280 patients, no electrocautery was used. Newborn vital signs, Apgar scores, umbilical cord blood parameters, newborn serum parameters collected within 6th postpartum hour, and rate of newborn intensive care unit admission were compared. The 1st and 5th minute Apgar scores were significantly higher in the electrocautery group; however, this difference lost its significance at the 10th minute. The median newborn pulse rate (148 (7) vs. 146 (6) beats per minute, = 0.026), umbilical cord blood pH, and partial oxygen pressure were significantly higher in the electrocautery group compared to the no-electrocautery group (7.34 ± 0.06 vs. 7.31 ± 0.06, < 0.001, and 25.5 (14.77) vs. 23 (16.08) mmHg, = 0.025, respectively). The median umbilical cord blood serum calcium level was 1.51 (0.64) mmol/L in the electrocautery group, which was significantly lower than 1.9 (0.82) mmol/L in the no-electrocautery group ( = 0.002). The incidence of hypoglycemia was significantly lower in the electrocautery group than in the no-electrocautery group (2.2% vs. 5.7%, = 0.035). Monopolar electrocautery during cesarean section affects the fetus, but it is safe to use it. Electrocautery is independently associated with umbilical cord blood pH and calcium level. Electrocautery may be associated with a lower incidence of hypoglycemia.
本研究旨在评估剖宫产术中使用单极电凝对胎儿的影响。对 552 例行剖宫产术的患者进行了回顾性分析。根据使用单极电凝的情况对患者进行分组。在 272 例患者中，在分娩前使用单极电凝分离组织。在 280 例患者中，未使用电凝。比较新生儿生命体征、阿普加评分、脐血参数、产后 6 小时内采集的新生儿血清参数以及新生儿重症监护病房入院率。电凝组第 1 分钟和第 5 分钟的阿普加评分显著升高，但在第 10 分钟时这种差异失去了意义。电凝组新生儿脉搏中位数（148（7）次/分钟比 146（6）次/分钟， = 0.026）、脐血 pH 和部分氧分压明显高于无电凝组（7.34 ± 0.06 比 7.31 ± 0.06， ＜0.001，和 25.5（14.77）比 23（16.08）mmHg， = 0.025）。电凝组新生儿脐血血清钙水平中位数为 1.51（0.64）mmol/L，明显低于无电凝组的 1.9（0.82）mmol/L（ = 0.002）。电凝组低血糖发生率明显低于无电凝组（2.2%比 5.7%， = 0.035）。剖宫产术中使用单极电凝会影响胎儿，但使用它是安全的。电凝与脐血 pH 和钙水平独立相关。电凝可能与低血糖发生率降低有关。
