Cesarean section for suspected fetal distress, continuous fetal heart monitoring and decision to delivery time.

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dc.contributor.authorRoy, K Ken_US
dc.contributor.authorBaruah, Jineeen_US
dc.contributor.authorKumar, Suneshen_US
dc.contributor.authorDeorari, A Ken_US
dc.contributor.authorSharma, J Ben_US
dc.contributor.authorKarmakar, Debjyotien_US
dc.date.accessioned2008-12-06en_US
dc.date.accessioned2009-05-30T10:46:44Z
dc.date.available2008-12-06en_US
dc.date.available2009-05-30T10:46:44Z
dc.date.issued2008-12-06en_US
dc.description.abstractOBJECTIVE: To find out the efficacy of continuous fetal heart monitoring by analyzing the cases of cesarean section for nonreassuring fetal heart in labor, detected by cardiotocography (CTG) and correlating these cases with perinatal outcome. To evaluate whether a 30 minute decision to delivery (D-D) interval for emergency cesarean section influences perinatal outcome. METHODS: This was a prospective observational study of 217 patients who underwent cesarean section at > or = 36 weeks for non-reassuring fetal heart in labor detected by CTG. The maternal demographic profile, specific types of abnormal fetal heart rate tracing and the decision to delivery time interval were noted. The adverse immediate neonatal outcomes in terms of Apgar score <7 at 5 minutes, umbilical cord thornH <7.10, neonates requiring immediate ventilation and NICU admissions were recorded. The correlation between non-reassuring fetal heart, decision to delivery interval and neonatal outcome were analyzed. RESULTS: Out of 3148 patients delivered at > or = 36 weeks, 217 (6.8%) patients underwent cesarean section during labor primarily for non-reassuring fetal heart. The most common fetal heart abnormality was persistent bradycardia in 106 (48.8%) cases followed by late deceleration in 38 (17.5%) cases and decreased beat to beat variability in 17 (7.8%) cases. In 33 (15.2%) babies the 5 minutes Apgar score was <7 out of which 13 (5.9%) babies had cord thornH <7.10. Thirty three (15.2%) babies required NICU admission for suspected birth asphyxia. Rest 184 (84.7%) neonates were born healthy and cared for by mother. Regarding decision to delivery interval of < or =30 minutes versus >30 minutes, there was no significant difference in the incidence of Apgar score <7 at 5 minutes, cord pH <7.10 and new born babies requiring immediate ventilation. But the need for admission to NICU in the group of D-D interval < or = 30 minutes was significantly higher compared to the other group where D-D interval was >30 minutes. CONCLUSION: Non-reassuring fetal heart rate detected by CTG did not correlate well with adverse neonatal outcome. There was no significant difference in immediate adverse neonatal outcome whether the D-D time interval was < or = 30 minutes or >30 minutes; contrary to this, NICU admission for suspected birth asphyxia in </= 30 minutes group was significantly higher.en_US
dc.description.affiliationDepartment of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India. drkkroy2003@yahoo.co.inen_US
dc.identifier.citationRoy KK, Baruah J, Kumar S, Deorari AK, Sharma JB, Karmakar D. Cesarean section for suspected fetal distress, continuous fetal heart monitoring and decision to delivery time. Indian Journal of Pediatrics. 2008 Dec; 75(12): 1249-52en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/78997
dc.language.isoengen_US
dc.source.urihttps://medind.nic.in/icb/icbai.shtmlen_US
dc.subject.meshCardiotocographyen_US
dc.subject.meshCesarean Sectionen_US
dc.subject.meshFemaleen_US
dc.subject.meshFetal Distress --diagnosisen_US
dc.subject.meshHumansen_US
dc.subject.meshPregnancyen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshTime Factorsen_US
dc.titleCesarean section for suspected fetal distress, continuous fetal heart monitoring and decision to delivery time.en_US
dc.typeJournal Articleen_US
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