Effect of Maternal Oxygenation with Spinal Anesthesia on Neonatal Outcome in Full Term Elective Cesarean Section

F. F. Negm, T. Assar, Doaa Samy Saad Abo Salem, H. Abdelbaset
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Abstract

Background: Understanding the implications of maternal oxygenation during elective cesarean sections with spinal anesthesia on neonatal outcomes is crucial for optimizing perinatal care. This study aimed to determine the effect of maternal oxygenation on neonatal outcome in full term elective cesarean section under spinal anesthesia. Methods: This randomized controlled trial, conducted from June to December 2022 at Benha University Hospital, included pregnant patients beyond 37 weeks of gestation undergoing elective cesarean section. Participants were divided into two groups: Group A received oxygen supplementation, while Group B did not. Various assessments, including maternal and neonatal parameters, were conducted. Results : Group A exhibited significantly higher maternal oxygen levels (100 ± 0 vs. 95 ± 1, P < 0.001). Neonates in Group A demonstrated lower umbilical vein carbon dioxide (35.3 ± 6.4 vs. 39.4 ± 7.8, P = 0.013) and bicarbonate levels (19.3 ± 2.7 vs. 21.6 ± 5.3, P = 0.019) but higher oxygen levels (34 ± 6 vs. 22 ± 4, P < 0.001). Apgar scores were higher in Group A at 1 minute (median = 9 vs. 8, P = 0.023), 10 minutes (median = 10 vs. 9, P < 0.001), and 20 minutes. Group A neonates also had significantly higher oxygen levels at 1, 3, 5, and 10 minutes post-delivery but there was no statistically significant difference in admission rate. Conclusion: Maternal oxygenation during elective cesarean sections may positively influences neonatal outcomes, as evidenced by improved Apgar scores and higher neonatal oxygen levels but no effect on admission rate.
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在足月择期剖腹产手术中,产妇在脊髓麻醉下吸氧对新生儿结局的影响
背景:了解脊髓麻醉下择期剖宫产术中产妇氧合对新生儿预后的影响对于优化围产期护理至关重要。本研究旨在确定在脊柱麻醉下行足月择期剖宫产术中产妇氧合对新生儿预后的影响。方法:这项随机对照试验于 2022 年 6 月至 12 月在本哈大学医院进行,包括妊娠超过 37 周、接受择期剖宫产手术的孕妇。参与者分为两组:A 组接受氧气补充,B 组不接受氧气补充。对产妇和新生儿的各项指标进行了评估。结果:A 组产妇的血氧含量明显更高(100 ± 0 对 95 ± 1,P < 0.001)。A 组新生儿的脐静脉二氧化碳浓度(35.3 ± 6.4 对 39.4 ± 7.8,P = 0.013)和碳酸氢盐浓度(19.3 ± 2.7 对 21.6 ± 5.3,P = 0.019)较低,但氧气浓度(34 ± 6 对 22 ± 4,P < 0.001)较高。在 1 分钟(中位数 = 9 对 8,P = 0.023)、10 分钟(中位数 = 10 对 9,P < 0.001)和 20 分钟时,A 组新生儿的 Apgar 评分更高。在分娩后 1、3、5 和 10 分钟,A 组新生儿的血氧水平也明显更高,但入院率在统计学上没有显著差异。结论产妇在选择性剖宫产过程中的吸氧可对新生儿的预后产生积极影响,Apgar 评分的提高和新生儿血氧水平的升高证明了这一点,但对入院率没有影响。
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