Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Delivery of baby by caesarean section has become increasingly common, Caesarean section can be performed under general or regional anaesthesia like spinal or epidural technique, and both have advantages and disadvantages. It is important to clarify what type of anaesthesia is safest for the mother and baby.
OBJECTIVE:
To compare the effect of spinal anaesthesia versus general anaesthesia on Apgar score of neonates born by elective caesarean section in Baghdad teaching hospital.
MATERIAL AND METHODS:
The study was carried out in Baghdad teaching hospital from February 2011 to July 2011 .this study was performed on 60 women presenting for Elective lower segment caesarean section .thirty mothers were given general anaesthesia and other 30 mothers received spinal anaesthesia. The Apgar score was recorded at1 minute and 5 minute interval after each delivery.
RESULTS:
Out of 30 mothers, who received general anaesthesia, 25 patients (83.3%) give birth to neonates having Apgar score ≤ 6 at one minute after birth and the remaining 5 neonates (16.7%) had Apgar score of ≥7.
On the other hand out of 30 mothers who received spinal anaesthesia only 10 mothers give birth to neonate having Apgar score ≤ 6 at one minute after birth, who improved at 5 minutes interval, and their Apgar score were ≥7.
It had been found that those neonates who were born under G.A were ten folds more likely to have Apgar score less than or equal to 6 at first minute compared to those with spinal anaesthesia, the odds ratio=10 and 95%confidence interval of the odds ratio (2.94-34) and p=0.00024 which is highly significant, G.A had greater risk on infant at the first minute.
CONCLUSION:
There is a significant difference between the effects of general anaesthesia and spinal anaesthesia on Apgar score of neonate one minute after delivery of full term neonate by elective caesarean section, but there is no significant difference between the effect of general anaesthesia and spinal anaesthesia on Apgar score 5minutes after birth.