Fluid preload before spinal anaesthesia in Caesarean section: the effect on neonatal acid-base status

Area of Science:

• Anesthesiology
• Neonatal Physiology
• Obstetrics

Background:

• Neonatal acid-base status is critical following Cesarean section.
• Fluid preload strategies aim to optimize maternal and neonatal outcomes.
• Ringer's lactate and 0.9% sodium chloride are common crystalloid solutions used for fluid preload.

Purpose of the Study:

• To compare the effects of Ringer's lactate versus 0.9% sodium chloride preload on neonatal acid-base status.
• To evaluate the impact of different fluid preload solutions on newborn infant well-being after elective Cesarean section.

Main Methods:

• Two groups of 20 healthy parturients received either Ringer's lactate or 0.9% sodium chloride (2 L crystalloid bolus) before spinal anesthesia.
• Maternal normotension was rigorously maintained during the procedure.
• Neonatal acid-base status and Apgar scores were assessed.

Main Results:

• No significant differences in Apgar scores at 1 and 5 minutes were observed between the groups.
• Umbilical artery PCO2 was lower in the Ringer's lactate group.
• A statistically insignificant increase in pH (0.03) was noted in the Ringer's lactate group.

Conclusions:

• The selection of Ringer's lactate or saline for fluid preload does not influence neonatal well-being.
• Both solutions are comparable in terms of neonatal outcomes following Cesarean section under spinal anesthesia.