Caesarean Section Anaesthesia and the Apgar Score

EDITORIAL COMMENT": We accepted this paper for publication because it carefully challenges a commonly expressed clinical opinion regarding the optimal anaesthesia for delivery at Caesarean section of the low birth‐weight infant. Our anaesthetist reviewer commented that the indication for Caesarean section was not considered and emphasized that Apgar scores have a poor correlation with fetal well‐being and should not therefore be considered as incontrovertible evidence for or consequence of poor operating conditions or birth trauma. A number of facts relating to general anaesthesic agents and their effects on the neonate are mentioned in the discussion. However, the extremely important concept of aortocaval compression and its effect on maternal cardiac output, peripheral resistance and the placental circulation was not. Summary: Retrospective comparison of epidural and general anaesthesia by a multivariate analysis of 1 and 5 minute Agar scores did not show that general anaesthesia improves operating conditions for Caesarean section or reduces fetal trauma for preterm and term infants.