Factors influencing spinal anesthesia-to-delivery interval in elective cesarean sections: A retrospective analysis

Previous research has shown that longer intervals from spinal anesthesia (SA) to cesarean delivery are associated with lower umbilical arterial pH levels. This study aimed to identify specific risk factors related to SA-to-delivery interval in elective cesarean sections. In this retrospective analys...

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Vydáno v:Medicine (Baltimore) Ročník 104; číslo 19; s. e42420
Hlavní autoři: Kinoshita, Michiko, Sakai, Yoko, Nakaji, Yoshimi, Takahashi, Rikako, Matsumoto, Yako, Tanaka, Katsuya
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 09.05.2025
Témata:
Adult
Anesthesia, Obstetrical - methods
Anesthesia, Spinal - methods
Anesthesia, Spinal - statistics & numerical data
Body Mass Index
Cesarean Section - methods
Cesarean Section - statistics & numerical data
Elective Surgical Procedures
Female
Humans
Hydrogen-Ion Concentration
Pregnancy
Retrospective Studies
Risk Factors
Time Factors
fetal distress
cesarean section
fetal blood
spinal
anesthesia
ISSN:1536-5964, 1536-5964
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Shrnutí:Previous research has shown that longer intervals from spinal anesthesia (SA) to cesarean delivery are associated with lower umbilical arterial pH levels. This study aimed to identify specific risk factors related to SA-to-delivery interval in elective cesarean sections. In this retrospective analysis, 404 singleton parturients who underwent elective cesarean sections with SA after 37 weeks of gestation were assessed. Factors influencing the SA-to-delivery interval were explored. The correlation between SA-to-delivery interval and umbilical arterial pH levels was also investigated in our cohort. Factors that significantly prolonged the SA-to-delivery interval included higher body mass index (BMI; regression coefficient [RC]: 0.206, P = .003), history of previous cesarean section (RC: 1.699, P = .012), placenta previa/low-lying placenta (RC: 6.141, P < .001), and local anesthetic administration into the epidural space following SA (RC: 3.279, P < .001). The SA-to-delivery interval was slightly yet significantly inversely correlated with umbilical arterial pH (r = -0.163, P = .001). A general linear model, adjusted for age, BMI, predominant ephedrine use, lowest systolic blood pressure between SA and delivery, diabetes mellitus, and hypertensive disorder of pregnancy have established the significant relationship between the SA-to-delivery interval and umbilical arterial pH (RC: -0.0012, P < .001). In conclusion, factors such as higher BMI, previous cesarean sections, placenta previa/low-lying placenta, and local anesthetic administration into the epidural space after SA significantly contributed to extended SA-to-delivery intervals. The SA-to-delivery interval was inversely correlated with umbilical arterial pH.
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ISSN:1536-5964
1536-5964
DOI:10.1097/MD.0000000000042420