Neonatal effect of prolonged anesthetic induction for cesarean section

The relationship of induction-to-delivery and uterine incision-to-delivery intervals to neonatal outcome was studied in 105 parturient women undergoing cesarean section. Sixty patients received general anesthesia and 55 were given spinal anesthesia. During general anesthesia, induction-to-delivery intervals of more than 8 minutes and uterine incision-to-delivery intervals of more than 3 minutes were associated with significantly more instances of neonatal acidosis (umbilical artery pH 7.31 versus 7.22) and a greater incidence of low 1-min Apgar scores (4% versus 73%). In the groups receiving spinal anesthesia, prolongation of uterine incision-to-delivery interval by more than 3 minutes was found to be the only important factor influencing fetal outcome, as determined by an increased acidosis (umbilical artery pH 7.30 versus 7.18) and by depressed Apgar scores (0% versus 62%).