Maternal and umbilical cord oxygen content and acid-base balance in relation to general, epidural or subarachnoid anesthesia for term elective cesarean section.

PURPOSE: To compare maternal and neonatal oxygenation and acid-base status after elective cesarean section (CS) under different anesthetic techniques. MATERIALS AND METHODS: Three hundred and eighty parturients undergoing elective cesarean section were randomly assigned to receive general (GA, n =140), epidural (EA, n = 117) or subarachnoid anesthesia (SA, n =123). Blood gases, oxygen content, and acid-base status parameters were measured in maternal artery and umbilical cord vessels. Neonatal Apgar scores were also recorded. RESULTS: Umbilical artery pH, HCO3-, and actual base excess (ABE) were significantly higher in the GA compared to SA group (p < 0.001, p < 0.05, andp < 0.05, respectively). Umbilical vein ABE was lower in the SA compared to GA and EA groups (p < 0.05). Oxygen content in maternal artery was higher in the GA and EA groups compared to the SA group (p < 0.05). Neonatal oxygen content in both cord vessels was higher in the GA group compared to EA and SA groups (p < 0.05). Umbilical venous-arterial difference of PO2, oxygen content, and Apgar scores did not differ significantly among groups. CONCLUSION: Neonatal oxygenation and acid-base status values were better preserved when GA was administered for elective CS compared to regional modalities. Apgar scores and neonatal outcomes were not affected by the anesthetic technique.