Early change in neurobehavior is strongly associated with the intelligence development of children. Previous studies reported that cesarean section itself could influence the later development of children. In addition, neuraxial anesthesia including epidural, spinal and combined spinal epidural anesthesia (CSEA) are the major forms used during cesarean delivery, and these anesthesia techniques will undoubtedly evoke hypotension and corresponding hemodynamic alteration, of which would result in decreasing in umbilical placental insufficiency and fetus hypoxia leading to early abnormality of neurobehaviors in infants. Fluid management, such as crystalloid and colloid, is the common ones given before or / and after neuraxial anesthesia to prevent or reverse hypotension. However, it is still unknown whether the perineuraxial anesthesia fluid resuscitation could improve the neurobehavior scorings, and could produce positive effect on later intelligence development. Herein the investigators hypothesized that effective perineuraxial anesthesia fluid management during cesarean section would prevent the occurrence of hypotension and improve infant's neurobehavior scorings.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
5,000
Ringer's Lactate 8 ml/kg was given intravenously before or after epidural, spinal or CSEA in cesarean section
Hydroxyethyl starch (6%) was given before or after epidural, spinal or CSEA in cesarean section
The Affiliated Nanjing Maternity and Child Health Care Hospital
Nanjing, Jiangsu, China
Neurobehavior evaluation with the Assessment of Preterm Infants' Behavior (APIB)
Time frame: Immediate after birth (0 min)
Apgar scoring
Time frame: One min and 5min after birth.
Umbilical-cord gases analysis
Time frame: At the time baby was born (0min)
Neonatal sepsis evaluation
Time frame: One hour after the baby was born
Neonatal antibiotic treatment
Time frame: One hour after the baby was born
Incidence of maternal side effects
Time frame: Analgesia initiation (0min) to successful vaginal delivery (this time encountered alteration with different women)
Neurobehavior evaluation with the Assessment of Preterm Infants' Behavior (APIB)
Time frame: 30min after birth
Neurobehavior evaluation with the Assessment of Preterm Infants' Behavior (APIB)
Time frame: 1h after birth
Neurobehavior evaluation with the Assessment of Preterm Infants' Behavior (APIB)
Time frame: 8h after birth
Neurobehavior evaluation with the Assessment of Preterm Infants' Behavior (APIB)
Time frame: 1d after birth
Neurobehavior evaluation with the Assessment of Preterm Infants' Behavior (APIB)
Time frame: 1wk after birth
Neurobehavior evaluation with the Assessment of Preterm Infants' Behavior (APIB)
Time frame: 1month after birth
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