A systematic review on impact of combined spinal epidural analgesia on neonatal outcomes during caesarean section

Background Combined spinal epidural (CSE) analgesia has grown in popularity as a labour analgesic. The present systematic review assesses neonatal outcomes linked to CSE analgesia in caesarean sections, emphasising foetal heart rate (FHR) abnormalities, Apgar scores and additional neonatal parameters. Methods Publicly accessible English databases, including PubMed and Google Scholar, were searched from 2005 to 2022. A total of 120 research documents were mined, with nine articles selected according to the established inclusion and exclusion criteria. Results Findings indicate that temporary FHR alterations, such as bradycardia, delayed decelerations, decreased accelerations and increased neonatal intensive care unit admission, are linked to CSE analgesia. No significant effect was observed on Apgar scores at 1 and 5 min nor on neonatal birth weights. Conclusion The study found that quick onset analgesia and flexibility of CSE analgesia justify its use during caesarean sections; however, medication selection and maternal monitoring are essential. Assessing its long-term neonatal consequences and high-risk applications needs more investigation.