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Retrospective study of association between choice of vasopressor given during spinal anaesthesia for high-risk caesarean delivery and fetal pH.
Int J Obstet Anesth 2010; 19(1):44-9IJ

Abstract

BACKGROUND

Phenylephrine given during spinal anaesthesia for low-risk caesarean section is associated with higher fetal pH than ephedrine. However, there is little evidence on the effects of ephedrine and phenylephrine in complicated pregnancies. The aim of this study was to compare umbilical artery pH with phenylephrine and ephedrine given during spinal anaesthesia where caesarean section was performed because of an increased risk of fetal compromise.

METHODS

We reviewed the case notes of all women at our hospital from 2000-2003 who had undergone high-risk caesarean section under spinal anaesthesia, where umbilical artery and venous pH had been recorded at delivery. Umbilical artery pH was compared by choice of vasopressor and multiple regression analysis was used to investigate the effects of other possible confounding variables.

RESULTS

One hundred and fifteen patients received no vasopressor, 122 ephedrine (group E) and 148 phenylephrine (group P). The median umbilical artery pH was 7.26 (IQR 7.21-7.30) for the no-vasopressor group, 7.27 (7.22-7.30) for group E and 7.28 (7.22-7.32) for group P (P=0.21). Using multiple regression analysis, the only variable associated with altered umbilical artery pH was a non-reassuring fetal heart trace.

CONCLUSIONS

Umbilical artery pH was similar whether ephedrine or phenylephrine was used to maintain maternal arterial pressure, which contrasts with studies of low-risk caesarean section.

Authors+Show Affiliations

Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK. drdavidcooper@aol.com

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19945278

Citation

Cooper, D W., et al. "Retrospective Study of Association Between Choice of Vasopressor Given During Spinal Anaesthesia for High-risk Caesarean Delivery and Fetal PH." International Journal of Obstetric Anesthesia, vol. 19, no. 1, 2010, pp. 44-9.
Cooper DW, Sharma S, Orakkan P, et al. Retrospective study of association between choice of vasopressor given during spinal anaesthesia for high-risk caesarean delivery and fetal pH. Int J Obstet Anesth. 2010;19(1):44-9.
Cooper, D. W., Sharma, S., Orakkan, P., & Gurung, S. (2010). Retrospective study of association between choice of vasopressor given during spinal anaesthesia for high-risk caesarean delivery and fetal pH. International Journal of Obstetric Anesthesia, 19(1), pp. 44-9. doi:10.1016/j.ijoa.2009.06.002.
Cooper DW, et al. Retrospective Study of Association Between Choice of Vasopressor Given During Spinal Anaesthesia for High-risk Caesarean Delivery and Fetal PH. Int J Obstet Anesth. 2010;19(1):44-9. PubMed PMID: 19945278.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrospective study of association between choice of vasopressor given during spinal anaesthesia for high-risk caesarean delivery and fetal pH. AU - Cooper,D W, AU - Sharma,S, AU - Orakkan,P, AU - Gurung,S, Y1 - 2009/11/27/ PY - 2009/01/02/received PY - 2009/05/01/revised PY - 2009/06/07/accepted PY - 2009/12/1/entrez PY - 2009/12/1/pubmed PY - 2010/3/26/medline SP - 44 EP - 9 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 19 IS - 1 N2 - BACKGROUND: Phenylephrine given during spinal anaesthesia for low-risk caesarean section is associated with higher fetal pH than ephedrine. However, there is little evidence on the effects of ephedrine and phenylephrine in complicated pregnancies. The aim of this study was to compare umbilical artery pH with phenylephrine and ephedrine given during spinal anaesthesia where caesarean section was performed because of an increased risk of fetal compromise. METHODS: We reviewed the case notes of all women at our hospital from 2000-2003 who had undergone high-risk caesarean section under spinal anaesthesia, where umbilical artery and venous pH had been recorded at delivery. Umbilical artery pH was compared by choice of vasopressor and multiple regression analysis was used to investigate the effects of other possible confounding variables. RESULTS: One hundred and fifteen patients received no vasopressor, 122 ephedrine (group E) and 148 phenylephrine (group P). The median umbilical artery pH was 7.26 (IQR 7.21-7.30) for the no-vasopressor group, 7.27 (7.22-7.30) for group E and 7.28 (7.22-7.32) for group P (P=0.21). Using multiple regression analysis, the only variable associated with altered umbilical artery pH was a non-reassuring fetal heart trace. CONCLUSIONS: Umbilical artery pH was similar whether ephedrine or phenylephrine was used to maintain maternal arterial pressure, which contrasts with studies of low-risk caesarean section. SN - 1532-3374 UR - https://www.unboundmedicine.com/medline/citation/19945278/Retrospective_study_of_association_between_choice_of_vasopressor_given_during_spinal_anaesthesia_for_high_risk_caesarean_delivery_and_fetal_pH_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(09)00128-9 DB - PRIME DP - Unbound Medicine ER -