Comparison of epidural and general anaesthesia for elective Caesarean delivery according to the effects on Apgar scores and acid-base status

The objective of this study was to determine the effects of lumbar epidural anaesthesia on the Apgar score and acid-base status of the newborn. Umbili cal artery blood gases were obtained in 85 singleton, term, uncomplicated p regnancies delivered by elective Caesarean section. The umbilical artery bl ood pH, PaCO2, PaO2 and HCO3 values and Apgar scores (1 and 5 minutes) were compared between lumbar epidural and general anaesthesia groups. General a naesthesia was used in 45 (52.9%) women and lumbar epidural anaesthesia in 40 (47.1%). Only 2 of the newborns exposed to epidural anaesthesia had umbi lical artery blood pH values 7.19 or less. The mean umbilical artery blood pH was found to be significantly lower in the newborns exposed to lumbar ep idural anaesthesia (p = 0.011), None of the newborns in the 2 groups were s everely depressed (Apgar scores less than 4). The mean umbilical artery blo od PaCO2, PaO2 and HCO3 values did not show any significant difference betw een the groups. In conclusion, lumbar epidural anaesthesia is associated wi th lower umbilical artery blood pH values, occasionally with severe fetal a cidaemia.