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Titre du document / Document title

Cesarean section for suspected fetal distress: Does the decision-incision time make a difference ?

Auteur(s) / Author(s)

CHAUHAN S. P. (1) ; ROACH H. (1) ; NAEF R. W. (1) ; MAGANN E. F. (1) ; MORRISON J. C. (1) ; MARTIN J. N. (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, ETATS-UNIS

Résumé / Abstract

OBJECTIVE: To compare perinatal outcomes in patients at term (37 weeks) in whom the decision-incision time for cesarean delivery was due to suspected fetal distress. STUDY DESIGN: All parturients who underwent cesarean delivery primarily for possible fetal distress during a three-year period were identified retrospectively. Student's t test and the X2 test were utilized, and P<.05 was considered significant. A regression analysis of decision-incision time i and umbilical arterial pH was performed. RESULTS: From 1991 to 1993, 1.3% (117/9,137) of term laboring patients underwent emergency cesarean delivery for the primary indication of possible fetal distress. In 61 patients (52%) the decision-incision time was 30 minutes, while it exceeded 30 minutes in the remaining 56 women. The two patient groups were similar in maternal demographics, antepartum complications, oxytocin usage, thick meconium, types ofabnormal fetal heart rate tracing prompting surgery, use of amnioinfusion (41% vs. 36%), general anesthesia (97% vs. 93%), mean birth weight and Apgar score < 7 at five minutes. Three adverse outcomes were observed more frequently in association with decision-incision time > 30 minutes: (1) lower mean (± SD) umbilical arterial pH (7.16 ± 0.15 vs. 7.26± 0.06, P=.001), (2) pH < 7.00 (8/61 vs. 0/56, P=.005), and (3) admission to the neonatal intensive care unit (P=.008). When the incision was made longer than 30 minutes after the decision, there was no apparent adverse neonatal or infant outcome. CONCLUSION: Although a cesarean decision-incision time <30 minutes is a desirable goal for the fetus possibly in distress, failure to achieve this goal is not associated with a measurable negative impact on newborn outcome.

Revue / Journal Title

Journal of reproductive medicine    ISSN  0024-7758   CODEN JRPMAP 

Source / Source

1997, vol. 42, no6, pp. 347-352 (15 ref.)

Langue / Language

Anglais

Editeur / Publisher

Science, St. Louis, MO, ETATS-UNIS  (1969) (Revue)

Mots-clés anglais / English Keywords

Fetal distress

;

Comparative study

;

Perinatal

;

Cesarean section

;

Incidence

;

Risk factor

;

Evaluation

;

Fetomaternal relation

;

Human

;

Pregnancy disorders

;

Fetal diseases

;

Maternal diseases

;

Surgery

;

Mots-clés français / French Keywords

Souffrance foetale

;

Etude comparative

;

Périnatal

;

Césarienne

;

Incidence

;

Facteur risque

;

Evaluation

;

Relation mère foetus

;

Homme

;

Gestation pathologie

;

Foetus pathologie

;

Mère pathologie

;

Chirurgie

;

Mots-clés espagnols / Spanish Keywords

Sufrimiento fetal

;

Estudio comparativo

;

Perinatal

;

Cesárea

;

Incidencia

;

Factor riesgo

;

Evaluación

;

Relación madre feto

;

Hombre

;

Gestación patología

;

Feto patología

;

Madre patología

;

Cirugía

;

Localisation / Location

INIST-CNRS, Cote INIST : 17097, 35400006732748.0070

Nº notice refdoc (ud4) : 2714626



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