A comparison of the effect of Ringer Lactate versus Sodium Chloride 0.9% on maternal and neonatal acid- base state in elective cesarean delivery

Abstract

The purpose of this study was to compare the effect of Ringer Lactate versus Sodium Chloride 0.9% on maternal and neonatal acid- base state in elective cesarean delivery. Materials and Methods: The present study was a double blind Randomized Clinical Trial on 48 patients aged 18-45 years with a physical status of ASA class I or II who were candidates for elective cesarean section under spinal anesthesia. During the surgery, fluid therapy was performed in a group (24 cases) with Sodium Chloride 0.9% and in the other group (24 cases) with Ringer Lactate solution. At the entrance to the surgery room, the standard monitoring of vital signs of the mother including non-invasive blood pressure, heart rate, SPO2 were recorded every 2 minutes to 10 minutes, then every 5 minutes to 30 minutes, and then every 10 minutes until the end of the surgery. Before and after surgery, blood samples were taken for arterial blood gas analysis. The amount of maternal acidosis, total volume of infused serum, bleeding volume, urine output, duration of surgery, hemodynamic changes, use of vasopressor and atropine were recorded and compared in the two groups. The neonate Apgar score was recorded in minutes 1 and 5, and immediately after the birth of the baby and clamping of umbilical cord, a sample of umbilical artery blood was taken to analyze arterial blood gas and to investigate the acid-base status. Results: In this study, the most common cause of cesarean section was the previous cesarean section in 32 (70.8%) cases. The incidence of acidosis in mothers of ringer lactate group was significantly lower than normal saline group, but the incidence of acidosis in newborns was not significantly different in the two groups. Hypotension was the most frequent complication among all parturients. In all periods of time, the hemodynamic changes were not significantly different between the two groups. In general, there was no significant difference between the two groups regarding the need for Ephedrine. 3 parturients (6.2%) needed Atropine and 3 (6.2%) needed to use Phenylephrine.