It is common to have a pediatrician in attendance at all cesarean sections(CS), despite the paucity of objective evidence supporting such a policy. Our study was designed to determine the need for a pediatrician to attend all CS. As the purpose of a pediatrician's presence at CS is to provide resuscitation for a low Apgar score, we looked at the incidence of low Apgar scores in three groups of patients. A database of 15,828 consecutive deliveries (1992-1996) was analyzed to determine the rates of low Apgar scores in the following groups of patients. Group A: Vaginal deliveries, Group B: CS under regional anesthesia without fetal indication (dystocia, malpresentation, multiple gestation, macrosomia, genital herpes, failed induction and previous CS), and Group C: CS for fetal indications (fetal distress, placenta previa, abruptio placentae, toxemia, cord prolapse and uterine rupture) and/or under general anesthesia. Intergroup comparisons for 1 minute Apgar scores less than 4, and 5 minute Apgar scores less than 7 were performed. Odds ratios (OR) and 95% confidence intervals (CI) were determined comparing Groups A and B (B/A); and Groups A and C (C/A). The data do not demonstrate a higher incidence of low Apgar scores in CS for non-fetal indications, thus suggesting that there is no need for a pediatrician at CS.Table

Table 1
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