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. 2016 Oct;66(Suppl 1):177-80.
doi: 10.1007/s13224-015-0831-5. Epub 2016 Jan 28.

Caesarean Section for Foetal Distress and Correlation with Perinatal Outcome

Richa Gangwar  1 , Sarita Chaudhary  1
Affiliations

Caesarean Section for Foetal Distress and Correlation with Perinatal Outcome

Richa Gangwar et al. J Obstet Gynaecol India. 2016 Oct.

Abstract

Background: The main documented indication of intrapartum caesarean section is foetal distress (MacKenzie and Cooke in BMJ 323(7318):930, 2001). Foetal distress indicates foetal hypoxia and acidosis during intrauterine life.

Purpose: To correlate the diagnosis of foetal distress and perinatal outcome.

Methods: This was a prospective observational study of women who underwent caesarean section for foetal distress as detected by cardiotocography and not responding to intrauterine resuscitation. The foetal Apgar score at 1 and 5 min was recorded and cord blood pH was measured in all cases. The neonatal outcome was studied with regard to the need for supportive ventilation and admission to NICU/nursery.

Results: In our study, 14.38 % cases diagnosed with foetal distress subsequently had poor outcome. Twenty-one babies had a 5-min Apgar score <7, required immediate resuscitation and were admitted in NICU. Twelve foetuses had a 1-min Apgar score <4, while there were three cases of severe birth asphyxia (Apgar score <4 at 5 min); of these, two babies died. The neonatal outcome was poorer in cases with associated complicating factors.

Conclusion: The diagnosis of foetal distress is imprecise and a poor predictor of foetal outcome-the result is a tendency for unnecessary caesarean sections. On the contrary, lack of adverse outcome could reflect that our unit makes decisions at a time before clinically significant foetal compromise occurs.

Keywords: Caesarean section; Cardiotocography; Foetal distress; Perinatal outcome.

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Conflict of interest statement

Richa Gangwar and Sarita Chaudhary declare that they have no conflict of interest. Ethical approval All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5). Informed consent Informed consent was obtained from all patients for being included in the study.

Figures

Fig. 1
Fig. 1
Neonatal outcome in cases with and without associated complicating factors
Fig. 2
Fig. 2
Relation of neonatal outcome with associated high-risk factors
See this image and copyright information in PMC

References

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