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.
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Conflict of interest
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.
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Dr. Richa Gangwar is a Senior Resident in Department of Obstetrics and Gynaecology at Lady Hardinge Medical College. Dr. Sarita Chaudhary is an Assistant Professor in Department of Obstetrics and Gynaecology at Lady Hardinge Medical College.
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Gangwar, R., Chaudhary, S. Caesarean Section for Foetal Distress and Correlation with Perinatal Outcome. J Obstet Gynecol India 66 (Suppl 1), 177–180 (2016). https://doi.org/10.1007/s13224-015-0831-5
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DOI: https://doi.org/10.1007/s13224-015-0831-5