Plasma Cortisol Concentrations During Caesarean Section

Abstract

The effects of extradural and general anaesthesia on the adrenocortical response to elective or emergency Caesarean section were studied in 72 patients. Maternal plasma concentrations of cortisol were measured before surgery, at delivery, and 30 and 60 min after skin incision. Umbilical vein and artery plasma cortisol concentrations at delivery were determined also. Maternal plasma cortisol concentrations in patients receiving extradural anaesthesia did not change significantly from control at any of the time intervals. In the general anaesthesia group concentrations were significantly increased from control, at 30 and 60 min after skin incision for elective Caesarean sections, and at 60 min after skin incision during emergency surgery. There were no significant differences between the mean umbilical vein and artery plasma cortisol concentrations compared within or between extradural or general anaesthesia groups. Extradural anaesthesia, in contrast to general anaesthesia, decreases the adrenocortical response to Caesarean section surgery by blocking afferent neurogenic pathways from the surgical site. The method of anaesthesia does not influence the fetal cortisol response.

The impact of height on the spread of spinal anesthesia and stress response in parturients undergoing caesarean section: a prospective observational study

“…Although maternal stress response was affected, the stress response in the fetus was not influenced by the use of spinal anesthesia in pregnant women with different body height in our study. This is similar to previous findings that fetal stress response is not affected by the type of anesthesia [ 27 ].…”

“…Pain relief could suppress the release of stress hormones during surgery [ 25 ]. Spinal and epidural anesthesia have been shown to reduce the maternal stress response during cesarean section compared with general anesthesia [ 26 , 27 ]. In the present study, our results indicated that the increase of maternal cortisol level in the taller group was significantly greater than that in the shorter group at end of surgery.…”

Natural Killer Cell Activity and Delivery: Possible Influence of Cortisol and Anesthetic Agents

“…It is, therefore, important to assess fetal cortisol levels and thus to try to understand which factors influence its relase. Namba et al [25] reported that the umbilical vein cortisol concentration was unaffected by the anesthetic method used; our own results agree with those of other authors [6,7] who demonstrated that umbilical vein cortisol concentrations are higher with epidural anesthesia (higher stress response) than with general anesthesia.…”

Role of pelvic sensory signalling during delivery in postpartum mental health

“…Parturition is characterized by a hormonal profile that is altered by obstetric intervention. Women who deliver vaginally have higher plasma levels of cortisol (Namba, Smith, Fox & Challis, 1980), β-endorphin (Goebelsmann, Abboud, Hoffman & Hung, 1984), oxytocin (Vasicka, Kumaresan, Han & Kumaresan, 1978), and norepinephrine and epinephrine (Irestedt, Lagercrantz, Hjemdahl, Hagnevik & Belfrage, 1982) at the time of delivery than women who deliver via cesarean with an epidural. Moreover, physiological differences between deliveries with and without obstetric intervention persist during the postpartum period (Nissen, Uvnas-Moberg, Svensson, Stock, Widstrom & Winberg, 1996; Zanardo, Nicolussi, Carlo, Marzari, Faggian, Favaro & Plebani, 2001).…”