scholarly journals FETAL OUTCOME AFTER CAESAREAN SECTION PERFORMED FOR FETAL DISTRESS BASED ON ABNORMAL CARDIOTOCOGRAPHY

2021 ◽  
Vol 29 (01) ◽  
pp. 13-16
Author(s):  
S`hahzadi Saima Hussain ◽  
Syeda Sitwat Fatima ◽  
Tanveer Shafqat ◽  
Qudsia Qazi

Objective: To determine the fetal outcome of Caesarean Sections (CS) performed for abnormal Cardiotocography (CTG) Material and Methods: This retrospective data review was conducted in Gynaecology and Obstetrics unit B of Lady Reading Hospital Peshawar from June 2015 till June 2016 after approval from the hospital ethical committee, using a non-probability convenient sampling technique. The hospital record of 234 patients who had CS for fetal distress was reviewed. Patients with singleton and term gestation, who had CS for fetal distress diagnosed based on abnormal Cardiotocography were included in the study.  The fetal outcome was noted in terms of Apgar score at 5 minutes, admission to neonatal intensive care unit (NICU), and perinatal mortality. Fetal blood sampling (FBS) and postnatal analysis of fetal arterial blood gases and PH were not carried out in any patient because of non-availability. The results are expressed in frequencies and percentages, shown in tables and figures. Results: In one year, a total of 1255 C-sections were performed. Amongst these, 234 (18.64%) patients fulfilling inclusion criteria were enrolled. Babies delivered with 5 minutes Apgar score of 7 or above were 166 (70.94%).  Twenty-one (8.97%) babies were admitted to NICU and perinatal mortality was 6 (2.54%).  Conclusion Out of 234 patients who underwent CS due to abnormal CTG, more than 2/3rd of patients had normal babies with an Apgar score of 7 or more, which indicates that abnormal CTG alone should not be used as an indication for CS  Keywords: Fetal Distress, CTG, Caesarean section

2010 ◽  
Vol 17 (04) ◽  
pp. 670-675
Author(s):  
BUSHRA BANO ◽  
UZMA HUSSAIN ◽  
BUSHRA ZAHID

To evaluate fetal Biophysical Profile as an effective technique for the assessment of fetal condition and to improve fetal outcome by early detection of fetal hypoxia. Design: Co relational study: Place and Duration of Study: The study was carried out for a period of one year from Oct 2004-Oct 2005 at Obstetrics and Gynecology Department of Fatima memorial hospital Lahore. Patients and Methods: All patientswith history of sluggish fetal movements and clinical suspicion of IUGR, were underwent BPP from 32-42weeks. 100 patients were selected and their BPP score was recorded and were followed till delivery. Those who went into spontaneous labor and who were induced monitored during labor and at any sign of fetal distress immediate caesarean section performed. APGAR score of newborn was noted at one and five minutes and those having poor APGAR score were resuscitated and were followed till one week after delivery. APGAR score was compared with BPP score. Results: During this study 100 BPP were performed. 34patients were primigravidas and 66 were multigravidas. Among 100 patients 73had a BPP score of 9-10/10, 21 patients had a score of 7-8/10 and 6 patients had 4-6/10.In 2 patients with 4/10score emergency caesarean section led to the delivery of neonates with APGAR score of 8 at 5 minutes. Majority of patients with normal BPS of 8-9/10 had good APGAR score of 7- 8/10.Only 8 patients having BPP of 9-10/10 had poor APGAR score 6/10 or <6/10. Conclusion: The fetal BPP appears to be an effective technique for assessment of fetal condition.


2017 ◽  
Vol 24 (03) ◽  
pp. 462-465
Author(s):  
Afsheen Memon ◽  
Aisha Abdullah Sheikh ◽  
Anisa Kamal

Objectives: To compare the effect of nuchal cord versus without cord aroundthe neck on mode of delivery and fetal outcome. Study design: Case control comparativestudy. Period: 1st August 2013 to 31st March 2014. Setting: Gyn /Obs Department at Sir SyedHospital Karachi. Material and Methods: A comparative study was carried out on 2 groupsof parturient ladies. The study group comprised of those ladies who at the time of delivery(vaginal delivery/caesarean-section) had clinically cord around the neck while the other group(control) did not have nuchal cord. Duration of labour, mode of delivery were noted. Perinataloutcome was measured in terms of Apgar score and NICU admission. High risk pregnancieswere excluded from the study. Result: Incidence of nuchal cord at the time of delivery was22.7%. A high rate of caesarean delivery observed in study group as compared to controlgroup (70 % vs 40%) (P value 0.00006). Fetal heart rate irregularities & meconium stainedliquor finding was not significantly different in two groups (p< 0.161) & (p<0.169) respectively.Similarly fetal outcome measured in terms of Apgar score at 1 & 5 min & NICU admissionwas also not significantly different between the two groups. Conclusion: A significant highrate of caesareans section rate was observed in the study group mainly due to fetal distress(FHR irregularities). This means cord around the neck is a risk factor & needs extra monitoringspecially through intermittent CTG monitoring during labour so that fetal distress can be pickedup early & emergency caesarean section can be performed to avoid fetal compromise.


2014 ◽  
Vol 21 (06) ◽  
pp. 1087-1091
Author(s):  
Saima Perveen ◽  
Farrukh Naheed ◽  
Mussarat Sultana ◽  
Azra Sultana

Objective: To observe the effect of abnormal Cardiotocography to delivery interval on perinatal outcome in terms of Apgar score. Study design: Descriptive case series study. Place and duration of study: Baqai Medical University department of obstetrics and gynecology Fatima Hospital Karachi from Jan 2011 to July 2011. Material and method: One hundred patients were registered who had pathological Cardiotocography. Bishop’s score was noted and decision to deliver the patient was made according to the abnormality, and bishop’s score. If bishop’s score was good and vaginal delivery was imminent, then her second stage was shortened by operative vaginal delivery. Fetal distress was managed by left lateral position, O2 inhalation and hydration. If delivery was not imminent then decision of urgent LSCS was made, meanwhile fetal distress was managed. Decision – delivery interval was recorded, and fetal outcome was noted in terms of Apgar score and resuscitation needed. Results: During this period one hundred pregnant women at term had pathological CTG for which they were delivered urgently. Among them 12% of parturients were delivered within 30 min ,68% delivered within 30-60 min , 12% delivered in 60-90 min and only 8% were delivered in 90-120 min. Seventy four (74%) of parturients were delivered by emergency lower segment caesarean section and 26% of parturients were delivered by instrumental vaginal delivery. Fetal outcome in terms of 1 min Apgar score ,38% of neonates had Apgar score of <7 ,46% had >7 and 16% had Apgar score of <5. This group of neonates required resuscitation and 5 min Apgar was good. No neonate was admitted in Neonatal unit. Conclusions: In this study it is concluded that with fetal heart rate abnormality, if fetus is delivered within 60 min, it is not associated with poor fetal and neonatal outcome, provided fetal distress is managed while preparing for emergency lower segment caesarean section.


2019 ◽  
Vol 2 (1) ◽  
pp. 13-16
Author(s):  
Summiya Siddique Malik ◽  
Sadaf Saeed ◽  
Sumaira Kanwal

Objective: Study was conducted for 6 months in PIMS Hospital Islamabad. Data was collected on self-structured Questionnaire, Respiratory distress scoring, Objective tools of Arterial blood gases and vital signs with signed consent. Methodology: The subjects were randomly allocated in experimental and control groups. Baseline data was collected and re-collected on Day 0 and Day 7 respectively and assessed using non-probability convenient sampling technique. Both groups were given standard medical and nursing care. Results: The experimental group was given single treatment regimen i.e. Deep breathing exercises (with 5-10 repetitions of each DBE being possible onto patient for 15-30 minutes twice daily). The control group was given 10-15 cycles of ISM with prior steam inhalation and nebulization with salbutamol for a period of 15-20 minutes for 35-45 minutes twice daily for a period of 07 days. Conclusion: The experimental group results show that deep breathing exercises are significantly effective in improving post burn complications like pneumonia in patients suffering from second degree inhalation burns.


Author(s):  
Yusrawati Yusrawati ◽  
Reno Muhatiah

Objective: To report a rare case of Beckwith-Wiedemann Syndrome with polyhydramnios. Methods: Reporting a case of Beckwith-Wiedemann syndrome with polyhydramnios. Results: Case of Mrs. Y, 27 years old woman, G2P1A0L1 preterm pregnancy (30-31 weeks) with polyhidramnios. From ultrasound found renomegaly, bilateral hyperechogenic polycystic kidney, and the karyotype result was 46,XX. Caesarean section was performed due to fetal distress. A female baby was born by caesarean section with birth weight of 1300 grams, 37 centimeters of body length, and APGAR score of 6/8. The congenital anomalies found were hepatomegaly, renomegaly, bilateral hyperechogenic renal polycystic, low set ears. The baby was died in NICU on day care 5th, with suspected of sepsis. Conclusion: Prenatal diagnosis of Beckwith-Wiedemann syndrome on fetus with polyhydramnios. [Indones J Obstet Gynecol 2017; 5-3: 185-188] Keywords: amniocentesis, beckwith-wiedemann syndrome, polyhydramnios, prenatal diagnostic, USG


2019 ◽  
Author(s):  
Alemwork Desta Meshesha ◽  
Muluken Azage ◽  
Endalkachew Worku ◽  
Getahun Gebre Bogale

Abstract Background Globally, every year, 2.5 million infants die within their first month of life. Neonatal asphyxia is the leading specific cause of neonatal mortality in low- and middle-income countries, including Ethiopia. Therefore, the aim of this study was to identify the determinants of birth asphyxia among newborns admitted in Amhara region referral hospitals, Ethiopia. Methods Facility-based unmatched case-control study was employed among 193 cases and 193 controls of newborns. Newborns admitted to neonatal intensive care units with admission criteria of birth asphyxia and without birth asphyxia were considered as cases (Apgar score<7) and controls (Apgar score>=7) respectively. Data were collected using a structured questionnaire by systematic random sampling technique with proportional allocation, and entered in to Epi-Info version 7 and exported to SPSS version 20 for statistical analysis. Bivariate and multivariable logistic regression models were fitted to identify determinants of birth asphyxia. Results Newborns with low birth weight (<2.5kg) had 8.94 higher odds of birth asphyxia than those whose weight at birth was >=2.5kg at birth (AOR: 8.94, 95% CI: 4.08, 19.56). Newborns born at health centers were 7.36 times more likely to develop birth asphyxia than those born at hospitals (AOR: 7.36, 95% CI: 2.44, 22.13). Newborns born using instrumental delivery were 3.03 times more likely to develop birth asphyxia than those delivered by vaginally (AOR: 3.03, 95% CI: 1.41, 6.49). Newborns from mothers with prolonged labor were 2 times more likely to suffer from birth asphyxia as compared to their counterparts (AOR: 2.00, 95% CI: 1.20, 3.36). Conclusion This study identified prolonged labor, instrumental delivery, delivered at health centers, and low birth weight were identified as determinants of birth asphyxia. Thus, intervention planning towards the identified determinants may be needed to reduce neonatal birth asphyxia.


Author(s):  
Kamlesh R. Chaudhari ◽  
Kushagra R. Chaudhari ◽  
Omkar M. Desai

Background: We aimed to evaluate the effect of Oligohydramnios on fetal outcome in terms of fetal distress, Meconium staining of amniotic fluid, birth weight, Apgar score of newborn babies, NICU admission, early neonatal morbidity and mortality.Methods: This was a prospective study of 156 antenatal patients booked at K. J. Somaiya medical college and research centre during the year January 2012 to December 2013 with gestational age between 30-40wks with AFI<5cms with intact membranes were analyzed for perinatal outcome.Results: The Caesarian section rate for fetal distress was 41% in patients with Oligohydramnios. Meconium staining of amniotic fluid was found in 30.7% patients. APGAR score at 5 minutes <7 was found in 6 patients (3.8%).Conclusions: Oligohydramnios has significant correlation with Caesarean section for fetal distress and low birth weight babies. Oligohydramnios is associated with high rate of pregnancy complication and increased perinatal morbidity and mortality. Oligohydramnios is a frequent occurrence demand careful evaluation, intensive parental counseling, fetal surveillance and proper antepartum and intrapartum care.


2021 ◽  
pp. 4-6
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana

Aim:To assess and compare the perinatal outcome among mothers with normal and abnormal amniotic uid volume. Method: A prospective comparative study was conducted for a period of one year from January 2020 to December 2020. Group I consist of 50 patients with normal amniotic uid and group II consists of 50 patients with either oligohydramnios or polyhydramnios. Amniotic uid index (AFI) was calculated using Phalen's four quadrant technique using ultrasound. The perinatal outcome was judged by assessing the fetal distress predicted by abnormal fetal heart rate (FHR) or meconium stained liquor, one minute and 5 minute Apgar score, frequency of admission to neonatal intensive care unit (NICU), baby weight of less than 10th percentile for gestation age and perinatal mortality. Results: Induction of labour, caesarean section and meconium stained liquor was found to be most common among the patients in group II (abnormal AFI) in comparison with normal AFI subjects and similarly the perinatal outcome measures like low birth weight, increased frequency of admission to NICU due to respiratory distress and a low APGAR score was more commonly found in abnormal AFI group and the difference was found to be statistically signicant. Conclusion: AFI measurement in antepartum or intrapartum period can help to identify women who need increased antepartum surveillance for pregnancy complications and such women should be managed in a special unit to combat the complications effectively.


2019 ◽  
Vol 10 (1) ◽  
pp. 60-63
Author(s):  
Shakila Khanum ◽  
Liza Chowdhury

Background: The trend of Caesarean section (CS) carried out is rising worldwide. One of the most common indications of CS is fetal distress which is based on the cardiotocograph (CTG) recording, abnormal fetal heart rate pattern and meconium stained liquor. The aim of this study was to carry out an audit of CS performed due to fetal distress in a tertiary care military hospital with a view to justify the methods for diagnosis of fetal distress to fetal outcome. Methods: This cross-sectional observational study was carried out over a period of 1 year and 6 months (July 2013 to January 2015) in the Combined Military Hospital (CMH), Dhaka. All pregnant women at or beyond 37 weeks of gestation who underwent CS for fetal distress were included. Neonatal outcome were assessed based on APGAR score and neonatal intensive care admission. Results: Among the 260 (100%) women who underwent CS due to fetal distress, mean age was 27.8 ± 5.3 years. More than half (54.6%) of the women were primigravida. Majority (48%) of the patients presented with spontaneous onset of labor and in 43% cases labor was induced by medical methods. In the majority (40%) of the patients, fetal distress was diagnosed by seeing abnormal patterns in CTG. During CS, signs of fetal distress was found in the majority (64.6%) of the patients (meconium stained liquor 42.3%, cord abnormality 13.5% and placental abnormality 8.8%). APGAR score of the newborn babies was abnormal (<7) in the majority (60%) cases. More than half of the newborn babies required admission in neonatal intensive care unit for different diagnosis. There was only 4 (1.5%) cases of neonatal death. Conclusion: The rate of CS for fetal distress in this study was comparable to other study findings and within recommendation of WHO. The high rate of identifiable causes of fetal distress as well as neonatal outcome justifies doing CS in these cases. Birdem Med J 2020; 10(1): 60-63


Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.


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