The Correlation Between the Duration of Fetal Extraction During Elective Cesarean Section and Low Apgar Score
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- Category: Vol. 80, March 2012
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The Correlation Between the Duration of Fetal Extraction During Elective Cesarean Section and Low Apgar Score,OMAR A. MOHAMED, MOHAMED HAMAM ABD-MANAF, MAHMOUD M.A. SOLIMAN and AHMAD S.S.A. RASHWAN
Abstract
Objectives: To explore the relation between the duration of fetal extraction during cesarean section and Apgar score.
Study Design: 100 pregnant women were included in the study to assess the relation between the Apgar score after elective cesarean section and the following:
- The duration of fetal extraction starting from initiation of anesthesia, either general or spinal, till clamping of the cord.
- The duration of fetal extraction starting from the incision of the uterus, till clamping of the cord.
Results: The interval between initiation of anesthesia till cord clamping ranged between 3.5 and 25.5min with mean (11.02±4.8). On the other hand the interval between uterine incision till cord clamping ranged between 0.25 and 4.5min with mean (1.74±1.01). There was no statistically significant correlation between initiation of anesthesia till cord clamping interval and Apgar score recorded after 1 minute and 5 minutes (p-value=0.575 and p-value=0.674, respectively), also no statistically significant correlation between uterine incision till cord clamping interval and Apgar score recorded after 1 minute and 5 minutes (p-value=0.329 and p-value=0.237, respectively).
However, the pregnant women with history of previous cesarean section showed increased duration of initiation of anesthesia till cord clamping, with highly significant correlation (p-value=<0.001). There was significant correlation between uterine incision till cord clamping interval and BMI of the pregnant women (p-value=0.005).
93 of the neonates delivered did not develop TTN, while the other 7 neonates developed TTN upon which they were admitted to NICU for further management. Gestational age at timing of the cesarean section was highly significant with TTN, with p-value=0.019. Also TTN was significant with male gender, much more than female one, with p-value=0.053 (as TTN developed in 6 male neonates compared to only 1 female neonate). Duration, either initiation of anesthesia till cord clamping interval or uterine incision till cord clamping interval, has no significant difference with development of TTN.
Conclusions: No correlation between the duration of fetal extraction (either initiation of anesthesia till cord clamping interval up to 25.5 minutes or uterine incision till cord clamping interval up to 4.5 minutes) and Apgar score recorded at 1 minute and 5 minutes.