Relation Of Abnormal Fetal Heart Rate & Intra-Operative Findings In An Emergency Cesarean Section


Background: Fetal distress in itself is a non-specific term include indicators such as an abnormal intrapartum fetal heart rate pattern, meconium stained amniotic fluid, low apgar scores or placental abnormality , it's not necessarily that an abnormality in one will reflected as an abnormality in the other or their may be none of these findings.Aim of study: To describe the relation between intrapartum fetal heart abnormalities and operative findings and neonatal outcomes in an emergency cesarean section . Patients and methods: A" cross sectional study" performed in Al-Yarmouk Teaching Hospital through the period from the 1st of July 2014 to the 1st of July 2016 on a convenient sample of 638women. Women participated in the study included: women in the labor room who delivered singleton, viable fetus, cephalic presentation, term size pregnancy with gestational age ≥37-40 weeks by emergency caesarian section for abnormal fetal heart rate As a part of the work protocol, the surgeons were instructed to document any findings that may be possible causes for the non-reassuring fetal heart rate as cord abnormality ( occult cord prolapse , true knots or entalengement) , placental abruption and rupture uterus , the placentae of those who have no intraoperative findings were send for histopathology. Results: Mean maternal age was 27.6±8.1 years and mean fetal weight was 3.2±0.6 Kg . 35.2 % of neonates with intra-operative problems needed admission to the neonatal care unit in comparison to 20.3% of those not facing such problems. This difference was significant (p= 0.021) There is significant association between maternal age and intraoperative abnormalities with P-value of 0.009%. No intraoperative findings were seen in 34% and 65.5% no placental finding were found on histopathology.Conclusions: Fetal distress may occur for several underlining causes. However, neither of them may reflect fetal asphyxia or acidosis and an abnormal cardiotocography may carries a false diagnosis of fetal distress.