Fetal acidemia associated with regional anesthesia for elective cesarean delivery

Scott W. Roberts, Kenneth J. Leveno, J. Elaine Sidawi, Michael J. Lucas, Mary Ann Kelly

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

Objective: To determine the prevalence, magnitude, and type of fetal acidemia associated with contemporary obstetric anesthetic techniques. Methods: Umbilical artery blood gases were obtained in 1601 singleton pregnancies delivered by elective cesarean. Results: General anesthesia was used in 371 (23%) women, epidural in 286 (18%), combined spinal-epidural in 659 (41%), and spinal in 231 (14%). Approximately 18% of infants exposed to regional anesthetics had umbilical artery blood pH values 7.19 or less, 42 (3%) infants had pH values less than 7.10, and nine (1%) had values 6.99 or less. The incidence of fetal acidemia was greater in spinal and combined spinal-epidural procedures compared to epidural anesthetics. Fetal acidemia was predominantly respiratory in type because carbon dioxide pressure was abnormally increased when fetal acidemia was diagnosed. Conclusions: Regional anesthesia is associated with fetal acidemia, occasionally severe, and has features of an acute respiratory type of acidemia. Fetal acidemia is less frequent with epidural anesthesia compared to subarachnoid techniques.

Original languageEnglish (US)
Pages (from-to)79-83
Number of pages5
JournalObstetrics and Gynecology
Volume85
Issue number1
DOIs
StatePublished - 1995

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Conduction Anesthesia
Anesthetics
Umbilical Arteries
Epidural Anesthesia
Carbon Dioxide
General Anesthesia
Obstetrics
Gases
Pressure
Pregnancy
Incidence

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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Fetal acidemia associated with regional anesthesia for elective cesarean delivery. / Roberts, Scott W.; Leveno, Kenneth J.; Sidawi, J. Elaine; Lucas, Michael J.; Kelly, Mary Ann.

In: Obstetrics and Gynecology, Vol. 85, No. 1, 1995, p. 79-83.

Research output: Contribution to journalArticle

Roberts, Scott W. ; Leveno, Kenneth J. ; Sidawi, J. Elaine ; Lucas, Michael J. ; Kelly, Mary Ann. / Fetal acidemia associated with regional anesthesia for elective cesarean delivery. In: Obstetrics and Gynecology. 1995 ; Vol. 85, No. 1. pp. 79-83.
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