OC03.07: Prediction of emergency cesarean section for fetal distress after labor induction in term small-for-gestational-age fetuses with Doppler signs of brain sparing

Background: The one-minute Apgar score, proven useful for rapid assessment of the neonate, is often poorly correlated with other indicators of intrauterine well-being. Fetal asphyxia is directly associated with neonatal acidosis. Umbilical cord pH is best indicator of fetal hypoxemia and hypoxemia leads to neonatal acidosis. In today scenario, fetal distress is the leading indication of emergency cesarean section.Methods: A observational cross-sectional study conducted of one year between march 2017 to February 2018; of full-term obstetric patients undergoing emergency cesarean section for fetal distress as an indication. All patients included are term gestation with low risk pregnancy excluding medical disorders and other complications of pregnancy. Immediately after delivery umbilical artertial cord blood from placental site collected and sent for pH determination and Apgar score calculated of newborn.Results: Emergency cesarean section was being done for fetal distress diagnosed based on guidelines for Intermittent auscultation; maximum patients had fetal bradycardia (240) followed by fetal tachycardia (12) and irregular rhythm (18). Relation between pH value and the fetal outcome babies who had low pH value. i.e. <7.1; had maximum referrals with poor Apgar score at 1 min (<3) and at 5 min (<3). Out of 270 babies 18 had Apgar score <3 at 1 min, out of which 10 continued to have Apgar score <3 at 5 mins. These babies were referred to department of pediatrics and were not alive beyond day 2-4.Conclusions: The values of mean Apgar score and cord blood pH decreases, which is inversely proportion to duration and severity of intrauterine/intra partum asphyxia. Umbilical arterial cord blood pH correlation was found to be significant with Apgar score in neonates delivered with indication as fetal distress.

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Puerperal Complications in a Tertiary Hospital

Nepal Medical College Journal ◽

10.3126/nmcj.v23i4.42226 ◽

2021 ◽

Vol 23 (4) ◽

pp. 329-333

Author(s):

Hima Rijal ◽

Suvana Maskey

Keyword(s):

Cesarean Section ◽

Surgical Site Infection ◽

Medical Condition ◽

Mode Of Delivery ◽

Fetal Distress ◽

Tertiary Hospital ◽

University Teaching ◽

Site Infection ◽

Emergency Cesarean Section ◽

Emergency Cesarean

Postnatal period is considered as an important part in reproductive life of women. Even though the antenatal phase and labour are utmost important, puerperal phase of pregnancy cannot be overlooked. Puerperal complication can sometime lead to diabilities for lifelong of women. For the prevention of postnatal complication, antenatal prepadareness is needed. The objective of this study was to find out the incidence of puerperal complications and associated risk factors. This is a retrospective, descriptive study conducted at Tribhuvan University Teaching Hospital, Department of Obstetrics and Gynaecology from April 2019 to March 2020. The cases of puerperal complications were noted from the record book from ward. The individual files were collected from record section. Data was collected from record files and analysed. Total number of deliveries were 4932 in one year. Out of which, 84 cases (1.7%) were admitted due to various puerperal complications. Majority of the women admitted with puerperal complications were between 21-29 years, 59.5%. Sixty-four percent (n=54) were primipara and 35.7%(n=30) were multipara. Seventy-six (90.5%) were term deliveries, 6(7%) were preterm and 2(2.4%) were post term deliveries. Sixty-two (74%) had emergency cesarean section as mode of delivery. Major indication of emergency cesarean section was fetal distress (29.8%, n=25). Surgical site infection (53/84,63%) was the commonest puerperal complication followed by puerperal sepsis (8/84,9.5%). Fifty- three cases of surgical site infection (SSI) were observed in patients who had undergone emergency cesarean section. Associated medical condition like hypertension, diabeties, anemia, obesity was seen in 33.5% (n=33) of the cases. Surgical Site Infection is the most common puerperal complication and commonly seen in women who had undergone emergency cesarean section.

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The Implications of Diagnosis of Small for Gestational Age Fetuses Using European and South Asian Growth Charts: An Outcome-Based Comparative Study

The Scientific World JOURNAL ◽

10.1155/2014/474809 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Gianpaolo Maso ◽

Mathota A. M. M. Jayawardane ◽

Salvatore Alberico ◽

Monica Piccoli ◽

Hemantha M. Senanayake

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Fetal Distress ◽

Growth Chart ◽

Growth Charts ◽

Intrauterine Death ◽

Emergency Cesarean ◽

Group 2 ◽

The Impact ◽

Group 1

The antenatal condition of small for gestational age (SGA) is significantly associated with perinatal morbidity and mortality and it is known that there are significant differences in birth weight and fetal size among different populations. The aim of our study was to assess the impact on outcomes of the diagnosis of SGA according to Bangladeshi and European antenatal growth charts in Sri Lankan population. The estimated fetal weight before delivery was retrospectively reviewed according to Bangladeshi and European growth references. Three groups were identified: Group 1-SGA according to Bangladeshi growth chart; Group 2-SGA according to European growth chart but not having SGA according to Bangladeshi growth chart; Group 3-No SGA according to both charts. There was a difference in prevalence of SGA between Bangladeshi and European growth charts: 12.7% and 51.7%, respectively. There were statistically significant higher rates in emergency cesarean section, fetal distress in labour, and intrauterine death (P<0.001) in Group 1 compared with Group, 2 and 3. No differences of outcomes occurred between Groups 2 and 3. Our study demonstrated that only cases diagnosed as SGA according to population-based growth charts are at risk of adverse outcome. The use of inappropriate prenatal growth charts might lead to misdiagnosis and potential unnecessary interventions.

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Prostaglandin E1, E2 and oxytocin in labor induction

Open Medicine ◽

10.2478/s11536-006-0038-3 ◽

2006 ◽

Vol 1 (4) ◽

pp. 416-418

Author(s):

Snezana Dragoljub Plesinac

Keyword(s):

Cesarean Section ◽

Prostaglandin E1 ◽

Neonatal Outcome ◽

Average Duration ◽

Fetal Distress ◽

Labor Induction ◽

Cesarean Sections ◽

Gynecology And Obstetrics ◽

Emergency Cesarean ◽

Clinical Center

AbstractThe risks of induction must be carefully weighed against the risks of allowing the pregnancy to continue and not inducing labor. The aim of the study was to show labor and neonatal outcome of 335 deliveries inducted in 2004 at Institute of gynecology and obstetrics Clinical Center of Serbia. Inductions were performed with PGE2, PGE1 and Oxytocin. The best ripening effect was noted in PGE2 group. The average duration of labor was 8.6h in PGE1group, 5.9h in PGE2 group and 10.4h in OT group. Sixty eight labors finished with cesarean section (20%). Comparing duration of labor, percentage of emergency cesarean sections, incidence of fetal distress during the labor we suggest Dinoprostone, placed intracervically, as an agent of choice for induction of labor.

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Tako-Tsubo cardiomyopathy after cardiopulmonary resuscitation during emergency Cesarean section in a 28 year old patient in the 31st week of pregnancy

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0036-1593213 ◽

2016 ◽

Vol 76 (10) ◽

Author(s):

K Kraft ◽

H Mooz ◽

A Puhl ◽

M Graf ◽

H Renz ◽

...

Keyword(s):

Cardiopulmonary Resuscitation ◽

Cesarean Section ◽

Emergency Cesarean Section ◽

Emergency Cesarean ◽

Tako Tsubo Cardiomyopathy

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A Case of Emergency Cesarean Section on Client with Pseudopregnancy

10.32592/zamen.2020.1.1.100 ◽

2020 ◽

pp. 1-6

Keyword(s):

Heart Rate ◽

Cesarean Section ◽

Fetal Heart Rate ◽

Medical Service ◽

Fetal Heart ◽

Placenta Previa ◽

Urban Hospital ◽

Emergency Cesarean Section ◽

Emergency Cesarean ◽

Rural Health Center

Pseudopregnancy detection is significant while as the false pregnancy may show all symptoms. It is important to differentiate it. This is a case report of a pseudopregnancy which led to an emergency cesarean section. A 28-year-old woman who claimed to 7-month pregnancy was brought to the rural health center by husband families complaining of vaginal bleeding. The woman refers to an urban hospital by Emergency Medical Service with the diagnosis of placenta previa. In the hospital, she underwent an emergency cesarean section due to a severe deceleration of fetal heart rate, prior to assessing by sonography. No fetus or signs of uterine or abdominal pregnancy were found. Wrong auscultation of the mother's heart rate instead of fetal heart rate seems to be the main error. It is required to pay more attention to the methods of differentiation of fetal heart rate from the mother's heart rate. This report enlightens false pregnancy and early differentiation.

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