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Multivariate analysis of factors associated with umbilical arterial pH and standard base excess after Caesarean section under spinal anaesthesia *
Author(s) -
Ngan Kee W. D.,
Lee A.
Publication year - 2003
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2003.02888.x
Subject(s) - medicine , ephedrine , anesthesia , caesarean section , phenylephrine , base excess , blood pressure , pregnancy , biology , genetics
Summary We have investigated the factors predicting umbilical arterial pH (UA pH) and standard base excess (UA BE) in 337 consecutive elective Caesarean sections performed under spinal anaesthesia. Multiple linear regression analysis was performed with UA pH and UA BE as the dependent factors. We found that the significant factors predicting UA pH were: use of ephedrine, uterine incision‐to‐delivery time, maximum decrease in systolic arterial pressure and the interaction between ephedrine use and duration of hypotension (adjusted R 2 = 0.39, F 15,321 = 15.4, p < 0.0001). The significant factors predicting UA BE were: use of ephedrine and the interaction between ephedrine use and duration of hypotension (adjusted R 2 = 0.52, F 15,321 = 25.0, p < 0.0001). We conclude that, in order to minimise the risk of fetal acidosis, ephedrine should not be used before delivery, uterine incision‐to‐delivery time should be as short as possible, and alpha‐agonists such as metaraminol or phenylephrine should be used to minimise both the magnitude and duration of hypotension.