The Correlation between the Duration of Fetal Extraction during Cesarean Section and Development of Transient Tachypnea of the Newborn

Abstract
Background: Opted to assess the relation between each of the induction delivery time and the uterine incision delivery time during CD with the incidence of TTN.
Study Design: A prospective cohort study.
Patients and Methods: We included 100 pregnant women who were delivered by CS under spinal anesthesia, (completed 37 weeks), having singleton, non-anomalous fetus, at Kasr El-Aini Hospital, Cairo University, from May 2014 to Decem-ber 2014. Two time intervals (in seconds) were recorded: A) The induction delivery interval (from the start of induction of anesthesia till cord clamping=I-C interval), B) The uterine incision delivery interval (from the time of uterine incision till cord clamping=U-C interval). Neonatal parameters as regard; gender, weight, & 5 minute Apgar score were reportedas well as the development of TTN.
Results: The reported I-C interval & U-C interval ranged between 335-999sec (mean ± SD; 696±129.7) & 23-66sec (mean ± SD; 48.7±14.32) respectively. The 5 minute Apgar score range was between 6 to 10 (median; 9) & the neonatal respiratory rate range was from 39/min to 66/min (median; 44). The 5 minute Apgar score did not show any correlation, neither with the different variables of the study, nor with the I-C & U-C intervals. Out of the 100 delivered neonates, 8 neonates (8%) developed TTN & were admitted to the NICU for further management. TTN development showed a signif-icant correlation with the Gestational Age (GA), otherwise, there had been no statistical correlation between the develop-ment of TTN and the duration of fetal extraction during CS.
Conclusion: According to our finding TTN is not related to the length of the operative procedure till fetal delivery in cases under spinal anesthesia. We recommend the need of carrying on studies with larger populations, to offer the optimal time limit safe for fetal delivery and other possible risks for the development of TTN.