Do all deliveries with elective caesarean section need paediatrician attendance?

J Matern Fetal Neonatal Med. 2012 Dec;25(12):2766-8. doi: 10.3109/14767058.2012.703722. Epub 2012 Jul 9.

Abstract

Aim: To determine whether paediatrician attendance to deliveries with elective caesarean section (CS) is really needed for term and also for preterm babies with 35-37 weeks gestational age.

Methods: Singleton newborns ≥35 gestational weeks without any identified risk factor were evaluated for resuscitation steps prospectively after CS under regional and general anaesthesia.

Results: 545 infants were included in the study. 150 (27.5%) of infants needed only supplemental oxygen and 23 (4.2%) neonates needed bag and mask ventilation. None of the babies needed cardiopulmonary resuscitation (CPR) (chest compression) or endotracheal tube insertion/epinephrine administration. More infants required supplemental oxygen and bag-mask ventilation in general anaesthesia delivery group compared to spinal/epidural anaesthesia group (35.5% vs. 24.4%, p = 0.29 for oxygen and 9.2 % vs. 2.3%, p < 0.0001 for bag-mask) The need for resuscitation steps was not statistically significantly different between neonates who were born in 35-37 gestational week and neonates who were born ≥38 week (p = 0.170 for supplementary oxygen, p = 0.442 for bag-mask ventilation).

Conclusion: There is not increased risk for chest compression and entubation for infants ≥ 35 gestation weeks without antenatally identified risk factors born with elective CS either under regional or general anesthesia and only 4.2% of the babies needed bag-mask ventilation, so a health care personel who knows basic NRP may be sufficient in the clinics where it is easy to achieve an advanced skilled health care personel when needed.

Publication types

  • Evaluation Study

MeSH terms

  • Anesthesia, Obstetrical / methods
  • Anesthesia, Obstetrical / statistics & numerical data
  • Cesarean Section* / adverse effects
  • Cesarean Section* / methods
  • Cesarean Section* / statistics & numerical data
  • Delivery Rooms* / organization & administration
  • Delivery, Obstetric / adverse effects
  • Delivery, Obstetric / methods
  • Delivery, Obstetric / statistics & numerical data
  • Elective Surgical Procedures* / adverse effects
  • Elective Surgical Procedures* / statistics & numerical data
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Intubation, Intratracheal / statistics & numerical data
  • Male
  • Needs Assessment*
  • Pediatrics*
  • Physician's Role
  • Pregnancy
  • Resuscitation / statistics & numerical data
  • Workforce