The Relation between the Time from Induction of Neuraxial Anaesthesia to Delivery and Umbilical Arterial Cord pH at Scheduled Caesarean Delivery

Abstract

Spinal anesthesia is the most commonly used technique for planned caesarean delivery owing to the rapid onset of effective anesthesia and avoidance of fetal exposure to anesthetic drugs and of maternal risks from general anesthesia. The major disadvantage of spinal anesthesia is maternal hypotension; Spinal hypotension occurs in up to 74% of planned caesarean deliveries when prophylactic vasopressor infusions are not used and is associated with fetal acidosis (Kinsella et al., 2018). Both maternal hypotension and prolonged intraoperative time intervals during this predelivery window contribute to adverse neonatal outcome but their relative clinical importance and critical thresholds warrant further investigation (Powell et al., 2017). This Prospective cohort study aimed to evaluate the relation between predelivery time intervals started from end of induction of spinal anesthesia till delivery and neonatal umbilical arterial pH at scheduled term caesarean delivery as a method to evaluate neonatal outcome. After obtaining approval from the Ain Shams maternity hospital ethical committee and written informed consents from all patients undergoing any elective caesarian section and meeting our inclusion criteria, study of the effect of time from spinal anesthesia to delivery in planned caesarean deliveries on neonatal outcome, primarily neonatal acidosis will be carried out for 220 adult female patients.