The effect of Ringer's lactate serum with 0.9% sodium chloride on maternal and neonatal acid status in elective cesarean section: a triple-blind randomized clinical trial

Clear changes in neonatal acid-base in the early minutes can have adverse effects on the hemodynamic status of the neonate; different serums have different effects on the acid-base status. Therefore, this study was performed with aim to compare the effects of 0.9% sodium chloride serum with Ringer lactate serum on maternal and neonatal acid-base status in elective cesarean section.

This triple-blind randomized clinical trial study was performed with participation of 48 pregnant women in 2018-2019. The first group received 0.9 sodium chloride serum and the second group received ringer lactate serum. Arterial blood samples before cesarean section (mother) and after cesarean section (mother and baby) and neonatal Apgar score in the first and fifth minutes were recorded and compared between the two groups. Data were analyzed by SPSS software (version 21) and independent t-test, paired t-test, Chi-square test, Mann-Whitney test, analysis of variance and repeated measures. P<0.05 was considered statistically significant.

All factors studied in ABG were significant between the two groups of mothers, indicating a higher acidity in the 0.9% sodium chloride group than the ringer-lactate group (p<0.05). On the other hand, there was no significant difference between the studied factors in neonates (ABG and Apgar scores) between the two groups (p>0.05).

0.9% sodium chloride compared to lactated ringer causes acidosis in mothers undergoing elective cesarean section with spinal anesthesia, but none of them has a significant effect on the acid-base status of the infant. Ringer's lactate serum seems to be a good alternative to 0.9% sodium chloride serum, especially in mothers who are at higher risk for acidosis.