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Related Experiment Videos

Is a paediatrician needed at all Caesarean sections?

S J Parsons1, S Sonneveld, T Nolan

  • 1Department of Paediatric Intensive Care, Children's Health Center of Northern Alberta, Edmonton, Canada.

Journal of Paediatrics and Child Health
|June 20, 1998
PubMed
Summary

Neonatal resuscitation needs vary by delivery type. A paediatrician is not routinely needed for repeat Caesarean sections under epidural anaesthesia but is recommended for those under general anaesthesia.

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Area of Science:

  • Obstetrics and Neonatal Care
  • Anaesthesiology
  • Paediatrics

Background:

  • The necessity of a paediatrician or paediatric registrar for neonatal resuscitation during vaginal delivery or Caesarean section (CS) remains undefined.
  • This study aims to clarify resuscitation requirements based on delivery mode and anaesthesia type.

Purpose of the Study:

  • To determine the level of neonatal resuscitation required based on delivery mode and anaesthesia.
  • To inform guidelines on the routine attendance of paediatric specialists at deliveries.

Main Methods:

  • Analysis of the Tasmanian Obstetric Audit data from 1980 to 1989.
  • Inclusion of term singleton deliveries, examining the need for intubation and Apgar scores at 1 minute.
  • Stratification by mode of delivery and type of anaesthesia.

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Main Results:

  • A total of 64,739 singleton term deliveries were analyzed.
  • Intubation rates for repeat CS under epidural anaesthesia were low (0.55%, 0.26% in 1985-89).
  • Relative risks for adverse outcomes were higher for CS under general anaesthesia compared to spontaneous vaginal delivery.

Conclusions:

  • Routine paediatrician attendance is not necessary for repeat CS under epidural anaesthesia.
  • Paediatrician presence is advised for repeat CS performed under general anaesthesia.
  • Findings support tailored attendance policies for neonatal resuscitation.