Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019, 163(2):147-154 | DOI: 10.5507/bp.2019.008

The influence of mode of anaesthesia for caesarean delivery on neonatal Apgar scores in the Czech Republic and Slovakia: secondary analysis of the results of an international survey in 2015

Hana Harazim^a, Petr Stourac^b, Jan Blaha^c, Monika Grochova^d, Radka Klozova^e, Pavlina Noskova^c, Dagmar Seidlova^f, Stanislava Richterova^g, Michal Svoboda^h, Jiri Jarkovsky^h, Xenia Silovaⁱ, Bozena Jezova^j, Jiri Steinbach^k, Martin Zemanek^l, Jitka Mannova^m, Jan Slavikⁿ, Zuzana Novakova^o, Lubica Misakova^p, Jozef Firment^d

^a Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic

^b Department of Paediatric Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic

^c Department of Anaesthesiology and Intensive Care Medicine, 1 ^st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic

^d Department of Anaesthesiology and Intensive Care Medicine, L. Pasteur University Hospital, Kosice, Slovakia

^e Department of Anaesthesiology and Intensive Care Medicine, 2 ^nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic

^f 2 ^nd Department of Anaesthesiology and Resuscitation, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic

^g Department of Anaesthesiology and Intensive Care Medicine, University Hospital Martin, Martin, Slovakia

^h Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic

ⁱ Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine in Hradec Kralove, Charles University and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic

^j Department of Anaesthesiology and Intensive Care Medicine, Opava Hospital, Opava, Czech Republic

^k Department of Anaesthesiology and Intensive Care Medicine, Horovice Hospital, Horovice, Czech Republic

^l Department of Anaesthesiology and Intensive Care Medicine, Chrudim Hospital, Chrudim, Czech Republic

^m Department of Anaesthesiology and Intensive Care Medicine, Havlickuv Brod Hospital, Havlickuv Brod, Czech Republic

ⁿ Department of Anaesthesiology and Intensive Care Medicine, Kosice-Saca Hospital, Kosice, Slovakia

^o Department of Anaesthesiology and Intensive Care Medicine, Piestany Hospital, Piestany, Slovakia

^p Department of Anaesthesiology and Intensive Care Medicine, Trencin Hospital, Trencin, Slovakia

Aims: The purpose of this international survey was to describe the impact of current practices and techniques of caesarean section on the neonatal Apgar score in the Czech Republic (CZE) and Slovakia (SVK).

Methods: All Czech and Slovak departments that provide obstetric anaesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in details all peripartum anaesthetic practices, delivered by anaesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE). Results and Discussions. We collected data of 10119 women who delivered 10226 newborns. A caesarean section was recorded in 25.1% of deliveries (CZE 23.2%; SVK 30%). General anaesthesia was used for caesarean section in 37.5% of the cases (CZE 40%, SVK 33%). There was no statistically significant difference in the Apgar score lower than 7 in the 1, 5 or 10 min in groups of general and regional anaesthesia for caesarean section, when only elective sections of in-term babies with birth weight over 2500 g were analyzed. We found no statistically significant differences in the Apgar score in newborns of women intubated for caesarean section in rocuronium (n=21; 2.2%) and suxamethonium (n=889; 93%).

Conclusion: We found no difference in neonatal outcomes in groups of general and regional anaesthesia for caesarean section when only out-of-risk newborns were analyzed. The risk factors were identified as follows: an acute caesarean section, preterm babies, birth weight less than 2 500 g, born in perinatological center and multiple pregnancy - second baby. Trial Registration: ClinicalTrials.gov (ID: NCT02380586) https://clinicaltrials.gov/ct2/show/NCT02380586

Keywords: caesarean section, Apgar score, rocuronium, suxamethonium, international survey, general anaesthesia, rapid sequence induction, neonatal outcome

Received: February 18, 2019; Accepted: March 4, 2019; Prepublished online: April 9, 2019; Published: June 25, 2019  Show citation