Background: Cesarean section is associated with increased risks for adverse obstetric and perinatal outcomes. Many factors may contribute in the unfavorable neonatal outcome during cesarean section. The AmericanCollege of Obstetricians and Gynecologists (ACOG) eventually acknowledged that in certain cases, elective cesarean delivery might be performed provided the physician believed that the procedure would promote the overall health and welfare of the woman and her fetus.
Objective: To compare the effects of general versus spinal anesthesia on neonatal outcome during elective cesarean section.
Patients and Methods: This study was conducted on 100 pregnant women who had elective cesarean section for singleton full term pregnancy in Al-Hussein University Hospital and Al-Shikh Zayd Al-Nahyan Hospital. They were divided into 2 groups (according to anesthesia type), each consists of 50 women: The 1^st group (general anesthesia group): was started by Thiopentone 5mg/kg and Succinylcholine 1-2mg/kg then intubation and maintenance by inhalational anesthesia (Isoflurane 0.5%), and after delivery of baby 100μg Fentanyl was given and the 2^nd group (spinal anesthesia group): where heavy Marcaine (heavy Bupivacaine) was used; 2-3 ml was injected via spinal needle (pencil-point) gauge 25 in L3-4 or L4-5 without using opioids.
Results: The percentage of delivered neonates who suffered respiratory distress (with or without NICU admission) was significantly higher in the general anesthesia group compared to the spinal anesthesia group [24% in group (A) vs 8% in group (B)]. Also, the percentage of delivered neonates who required NICU admission was significantly higher in the general anesthesia group. There was also increased evidence of respiratory depression in neonates of women who delivered under general anesthesia as shown by the mean of Silverman Anderson retraction, the mean of Downes' score in neonates, the mean of Apgar score at 1 minute and the mean of Apgar score at 5 minutes. There was a statistically significant difference between the two study groups as regards the percentage of male and female neonates in relation to total number of delivered neonates who suffered respiratory distress in each group.
Conclusion: The incidence of neonatal respiratory morbidity and NICU admission occurred more often with the use of general compared to spinal anesthesia in elective cesarean sections. Clinicians considering the use of general anesthesia for a cesarean delivery should be aware of these possible consequences for the infant, for both planned and emergency cesarean sections.