Study On The Effects Of Different Ventilations On Maternal, Fetal Oxygenation Indicators And Placental Stereology

ObjectivesUsing three different ventilatinos during obstetrical anesthesia to study its effecton the umbilical cord blood lactic acid value (UCBLAV), blood gas and the placentalmicro vascular stereology, thus exploring the most conducive ventilation as aprecaution against maternal amd fetal anoxia.Methods30cases of singelton fulll-term women undergoing elective cesarean delivery,after admittion were randomly allocated to I, II, III (10in each). I being withoutartificial ventilation, II being given oxygen in4L/min with facemask, III being givenoxygen in4L/min with nasal catheter. Patients were given Gelofusine in11mL/(kg·h)as fluid infusion preoperatively. During operation, Gelofusine is still given till fetuseswere delivered. All patients were turned into left lateral position when administered1.6mL of lidocain over30seconds as anesthesia in cavum subarachnoidale betweenL3and L4. Then patients lay on their backs on operation table with a30°tilt to the left.Monitor and record differences of blood pressure, heart rate and oxyhemoglobinsaturation at pre-anethesia(T0),5min(T1),10min(T2),15min(T3),20min(T4) intoanesthesia, delivery(T5) and5min of delivery(T6). Compare the Apgar scoring anddifference of UCBLAV, blood gas, oxyhemoglobin saturation at1min and5min of3group of neonatuses. Extract the central, placental tissue near the umbilical cord forimmunohistochemical staining. Study the length, density and volume difference ofcapillaries using stereological method.Result1. Among3groups of neonatuses, differences of the Apgar scoring, pH, PaCO2,PaO2, Hct and Hb of umbilical arterial blood taken at1min and5min are notstatisticaly significant(P>0.05)2. Among3groups of patients, differences of HR, SBP, DBP are not statisticaly significant(P>0.05).3. Among3groups of puerperae, SPO2of II and III are higher than in I, withstatistical significance(P<0.05).4. Among3groups of patients, UCBLAV of II is higher than I and III, withstatistical significance(P<0.05).5. Among3groups of patients, volume and density of placental capillaries of II ishigher than I and III, with statistical significance(P<0.05); while difference of thelength of placental capillaries is not statisticaly significant(P>0.05).ConclusionDuring cesarean section operation, group using ventilation via facemask showsincrease inoxygen content in puerperae and fetuses, from which is concluded thatartificial ventilation is necessary meassure during cesarean section. From analysis onUBCLAV and volume and density of placental capillaries, it is concluded thatfacemask is the most beneficial kind of ventilation, for it increases oxygen reserve,emliminates tissular hypoxia, inhences placental oxygen supply and funtions andeffectively prevents anoxia caused by contraction and other factors. Therefore it isrecommended for puerperae during perioperative cesarean section.