Maternal hypotension and neonatal acidemia during Caeserean delivery under spinal anaesthesia

Abstract

Objectives: To determine the incidence of neonatal acidaemia following delivery through caesarean section under spinal anaesthesia and determine the prevalence of maternal hypotension during Caesarean section under spinal anaesthesia and its correlation with neonatal acidaemia. Design: Prospective observational study Setting: Kenyatta National Hospital (KNH), Nairobi, Kenya. Subjects: One hundred and seventy-two ASA I and II consecutive term patients undergoing elective Caesarean section under spinal anaesthesia Results: Forty three babies (27.2%) were born with neonatal acidaemia, defined as umbilical arterial blood pH≤ 7.2. There was, however, no significant difference in the five minute Apgar scores between the acidotic and non-acidotic neonates. Twenty eight patients (17.7%) developed maternal hypotension (systolic Blood Pressure less than 100mmHg). The hypotension was readily corrected within two minutes (mean of 1.43 minutes) of onset using vasopressors and boluses of intravenous fluids. Conclusions: A short period (<2 minutes) mean of 1.43 minutes of maternal hypotension has no significant effect on the neonate as assessed by five minute Apgar Scores. Similarly, neonatal acidaemia following Caesarean delivery under spinal anaesthesia does not seem to have any short-term effects on neonatal well-being.