Pediatrician attendance at cesarean delivery: Necessary or not?

Objective: To determine whether it is necessary for a pediatrician to atten d all cesarean deliveries. Methods: We analyzed a database of 17,867 consecutive deliveries to determi ne the rates of low Apgar scores in the following three groups of patients: those with vaginal delivery, cesarean delivery using regional anesthesia w ithout fetal indication, and cesarean delivery for fetal indications or usi ng general anesthesia. Results: There was a significantly higher rate of low Apgar scores in the f etal indications or general anesthesia group when compared with vaginal del iveries. Specifically, 35 (5.8%) of 596 cesareans for fetal heart rate abno rmality or using general anesthesia had 1-minute Apgars under 2 in contrast to 115 of 10,270 (1.1%) of vaginal deliveries. There was no significantly increased risk for low Apgar scores in the group of cesareans using regiona l anesthesia for nonfetal indications (33 of 2057, 1.6%). Results were simi lar for Apgar scores under 7 at 5 minutes. Conclusion: Because there is no higher incidence of low Ap,oar scores in ce sarean deliveries using regional anesthesia for nonfetal indications compar ed with vaginal deliveries, there is no convincing need for pediatrician at tendance at such deliveries. (C) 1999 by The American College of Obstetrici ans and Gynecologists.