Exploration of the relationship between puerperal shivering and amniotic fluid entering into the blood during cesarean section

Objective To investigate the relationship between shivering and amniotic fluid entering into the blood during cesarean section, and provide new thoughts for prevention and treatment of shivering during cesarean section. Methods This was a prospective, double-blinded, and controlled study. A total of 57 puerperants [American Society of Anesthesiologists (ASA)ⅠorⅡ] received subarachnoid block, whose shivering were observed and classified by chief anesthesiologists. Their general information (name, age, height and weight), blood loss, fluid intake, gestational age, neonatal weight, the length of operation, neonatal 1 minute Apgar score and shivering grade were recorded. Their anal temperatures before anesthesia, 30 min after anesthesia and at the end of the operation were measured and recorded. The puerperants were divided into four groups according to Dewitte shivering classification: grade 0 is a non-shivering group (group 0); shivering grades 1 to 3 were divided into groups 1, 2 and 3, respectively, where groups 1 to 3 were defined as shivering groups. Then, 2 ml of venous blood were taken from all the puerperants before the end of the operation to detect the concentration of sialyl Tn (sTn) antigen. The correlations between shivering degree and sTn antigen concentrations, gestational age, blood loss, fluid intake, the length of operation, neonatal weight and anal temperature at three time points were analyzed. Results There was no significant difference in age, height, weight, blood loss, fluid intake, gestational age, neonatal weight, the length of operation, and anal temperature at three time points among these groups (P>0.05). Compared to groups 0 and 1, groups 2 and 3 produced higher concentrations of sTn antigen (P<0.05), while the concentration of sTn antigen in group 1 was higher than that in group 0 (P< 0.05). The concentrations of sTn antigen in the shivering groups were significantly higher than that in the non-shivering group (P<0.05). The correlation coefficient between shivering degree and sTn antigen concentration was 0.895 (P<0.01). There was no correlation between shivering degree and gestational age, blood loss, fluid intake, the length of operation, neonatal weight and anal temperature at three time points. Conclusions Puerperant shivering is related with amniotic fluid entering into the blood during cesarean section. Key words: Cesarean section; Shivering; Amniotic fluid; Sialyl Tn antigen