Do all deliveries with elective caesarean section need paediatrician attendance?

Abstract

Aim: To determine whether paediatrician attendance to deliveries with elective caesarean section (CS) is really needed for term and also for preterm babies with 35–37 weeks gestational age. Methods: Singleton newborns ≥35 gestational weeks without any identified risk factor were evaluated for resuscitation steps prospectively after CS under regional and general anaesthesia. Results: 545 infants were included in the study. 150 (27.5%) of infants needed only supplemental oxygen and 23 (4.2%) neonates needed bag and mask ventilation. None of the babies needed cardiopulmonary resuscitation (CPR) (chest compression) or endotracheal tube insertion/epinephrine administration. More infants required supplemental oxygen and bag-mask ventilation in general anaesthesia delivery group compared to spinal/epidural anaesthesia group (35.5% vs. 24.4%, p = 0.29 for oxygen and 9.2 % vs. 2.3%, p < 0.0001 for bag-mask) The need for resuscitation steps was not statistically significantly different between neonates who were born in 35–37 gestational week and neonates who were born ≥38 week (p = 0.170 for supplementary oxygen, p = 0.442 for bag-mask ventilation). Conclusion: There is not increased risk for chest compression and entubation for infants ≥ 35 gestation weeks without antenatally identified risk factors born with elective CS either under regional or general anesthesia and only 4.2% of the babies needed bag-mask ventilation, so a health care personel who knows basic NRP may be sufficient in the clinics where it is easy to achieve an advanced skilled health care personel when needed.

Keywords::

• Elective caesarean section
• paediatrician
• resuscitation

Declaration of Interest: The authors report no conflicts of interest.