Intrapartum Analysis of Lower Segment Cesarean Section Undertaken for Clinically Diagnosed Foetal Distress
Journal Title: Interventions in Gynaecology and Women’s Healthcare - Year 2018, Vol 1, Issue 3
Abstract
Abstract: Clinically diagnosed foetal distress (non reassuring foetal heart rate, meconium stained liquor, altered foetal movement) is one of the leading cause of cesarean section. This study was done for evaluation and correlation of intraoperative condition and neonatal status associated with clinically diagnosed foetal distress. Methodology: It was a hospital based observational study done in tertiary care hospital in women with clinically diagnosed foetal distress - non reassuring foetal heart rate, meconium stained liquor, altered foetal movement were included in study a details history was taken and intraoperative factors- Liquor (amount and colour), Placenta, Cord were noted. Detailed record of neonatal status was recorded. All data was collected and analyzed. Result: Among 139 women with clinically diagnosed foetal distress 51% had not reassuring foetal heart rate, 21.5% had meconium Stained liquor, 27.3% had altered foetal movement. Evaluation showed 9.8% had meconium stained liquor 45% had nuchal cord, 8.4% had abruptio placenta in non reassuring foetal heart rate cases. 31.5% had nuchal cord, 13.1% liquor was absent and in 2.6% liquor was meconium stained in altered foetal movements cases. Nuchal cord was present in 6.6% cases with meconium stained liquor. Apgar score of <7/10 and birth weight <2.5 kg present in 10.7% &23% cases respectively. Average neonatal intensive care unit stay was of 7 days and among them meconium aspiration syndrome were maximum. Conclusion: Careful evaluation should be done for clinically diagnosed Meconium Stained Liquor, altered foetal movement & nonreassuring foetal heartrate. Over diagnosis of foetal distress & misinterpretation of foetal heartrate increased the hospital burden of cesarean section. This points the need to confirm foetal distress diagnosed clinically with foetal blood acid base study & cardiotocography monitoring if possible or using two parameters for better reliability. Foetal distress is one of the leading cause of cesarean section. Assessment of fetus is by counting of the foetal heart rate (FHR) and checking for the presence of meconium in the liquor and womans daily foetal movement count. Abnormal FHR pattern, especially in the presence of meconium in the liquor, signifies foetal hypoxia and acidosis [1]. The introduction of foetal scalp blood pH estimation and electronic foetal monitoring into labour management has decreased the reliability on clinical methods, however the detection of abnormal FHR or rhythm and meconium staining of liquor still represents the best available indirect evidence of poor foetal oxygenation during labour in resource constrained settings and helps identify significant fetuses with possible early neonatal acidaemia and selecting foetuses that requires expedited delivery and supportive therapy at birth in low resource settings [2].
Authors and Affiliations
Nupur Hooja, Premlata Mital, Nidhi Sharma, Smriti Bhargava, Bhomraj Kumawat, Manisha Kala, Surabhi Arora, Kritika Tulani
Keywords
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- EP ID EP570034
- DOI 10.32474/IGWHC.2018.01.000115
- Views 86
- Downloads 0
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