IMPACT OF DIFFERENT ANESTHETIC TECHNIQUES ON MATERNAL, FETAL, AND NEONATAL STATES AFTER ABDOMINAL DELIVERY

Objective. To comparatively analyze maternal central hemodynamic parameters, fetal gaseous homeostasis, acid-base state (ABS), and perinatal outcomes after abdominal delivery under different anesthetic modes. Subject and methods. The investigation enrolled 65 pregnant women undergoing cesarean delivery under general and spinal anesthesia (GA and SA). Noninvasive bioimpedance technology was used to measure central hemodynamic parameters at surgical stages. The neonatal infants were evaluated using Apgar scoring at 1 and 5 minutes after birth. Umbilical venous blood gaseous homeostasis and ABS were examined. Results. At all surgical stages, the SA group presented a more favorable hemodynamic profile than did the GA group. The application of GA was followed by lower Apgar scores at 1 minute; no differences were found at 5 minutes. The study groups showed no great differences in umbilical venous blood pH, standard base excess, and lactate levels. In the GA group, the oxygen saturation in umbilical blood was significantly higher than that in the SA group. All the neonates had no complications in the early neonatal period. Conclusion. This study demonstrates a greater hemodynamic stability after cesarean section under SA. The GA newborn babies had higher umbilical blood oxygen saturation levels; however, both anesthetic modes indicated that adequate uteroplacental perfusion was preserved and they were safe for the fetus.

cesarean section, anesthesia, central hemodynamics, neonatal infants