Intrapartum Analysis of Lower Segment Cesarean Section Undertaken for Clinically Diagnosed Foetal Distress:(IGWHC)-Lupine Publishers
Intrapartum Analysis of Lower Segment Cesarean Section Undertaken for Clinically Diagnosed Foetal Distress by Premlata Mital in IGWHC in Lupine Publishers
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.
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