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Clinical suspicion, management and outcome of intrapartum foetal distress in a public hospital with limited advanced foetal surveillance

Clinical suspicion, management and outcome of intrapartum foetal distress in a public hospital with limited advanced foetal surveillance
Clinical suspicion, management and outcome of intrapartum foetal distress in a public hospital with limited advanced foetal surveillance
Objectives: To determine the basis for the clinical suspicion of foetal distress, the instituted managements and delivery outcome in a tertiary hospital in sub-Saharan Africa with limited capability for advanced foetal monitoring.
Methods: It is a 3-year retrospective analysis of all the obstetrics cases with intrapartum foetal distress.
Results: There were 301 cases reviewed. The birth asphyxia incidence rate was 233/1000 live births and the perinatal death rate was 47/1000 live births. Suspicion of foetal distress was premised on the presence of persistent tachycardia or bradycardia during intermittent auscultation. Main resuscitative measures were left lateral repositioning of patient, fast saline infusion, intranasal oxygen administration and discontinuation of oxytocin infusion, if any. Only 124 (41.2%) of all the cases had delivery achieved within 2?h of diagnosis. Mean decision-delivery interval by caesarean section was 2.93?±?2.05?h. Socio-demographic factors (p=?0.001) and pregnancy risk category (p?=?0.002) influenced incidence of birth asphyxia.
Conclusion: To reduce subsisting high perinatal morbidity and mortality in sub-Saharan Africa, it is best that at the least referral hospitals should have advanced facilities for foetal monitoring and shortened surgical intervention time.
asphyxia, electronic monitoring, intermittent auscultation, labour, sub-Saharan Africa
1476-7058
1-6
Adanikin, Abiodun, Idowu
7c475e5b-223b-4d26-9b60-85b32af15727
Awoleke, Jacob Olumuyiwa
57adb1ff-5884-4c29-a869-5d1300029429
Adanikin, Abiodun, Idowu
7c475e5b-223b-4d26-9b60-85b32af15727
Awoleke, Jacob Olumuyiwa
57adb1ff-5884-4c29-a869-5d1300029429

Adanikin, Abiodun, Idowu and Awoleke, Jacob Olumuyiwa (2016) Clinical suspicion, management and outcome of intrapartum foetal distress in a public hospital with limited advanced foetal surveillance. The Journal of Maternal-Fetal & Neonatal Medicine, 1-6. (doi:10.1080/14767058.2016.1174991).

Record type: Article

Abstract

Objectives: To determine the basis for the clinical suspicion of foetal distress, the instituted managements and delivery outcome in a tertiary hospital in sub-Saharan Africa with limited capability for advanced foetal monitoring.
Methods: It is a 3-year retrospective analysis of all the obstetrics cases with intrapartum foetal distress.
Results: There were 301 cases reviewed. The birth asphyxia incidence rate was 233/1000 live births and the perinatal death rate was 47/1000 live births. Suspicion of foetal distress was premised on the presence of persistent tachycardia or bradycardia during intermittent auscultation. Main resuscitative measures were left lateral repositioning of patient, fast saline infusion, intranasal oxygen administration and discontinuation of oxytocin infusion, if any. Only 124 (41.2%) of all the cases had delivery achieved within 2?h of diagnosis. Mean decision-delivery interval by caesarean section was 2.93?±?2.05?h. Socio-demographic factors (p=?0.001) and pregnancy risk category (p?=?0.002) influenced incidence of birth asphyxia.
Conclusion: To reduce subsisting high perinatal morbidity and mortality in sub-Saharan Africa, it is best that at the least referral hospitals should have advanced facilities for foetal monitoring and shortened surgical intervention time.

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More information

Accepted/In Press date: 3 April 2016
e-pub ahead of print date: 6 April 2016
Published date: 25 April 2016
Keywords: asphyxia, electronic monitoring, intermittent auscultation, labour, sub-Saharan Africa
Organisations: Social Statistics & Demography

Identifiers

Local EPrints ID: 394251
URI: https://eprints.soton.ac.uk/id/eprint/394251
ISSN: 1476-7058
PURE UUID: 8558ac30-72f7-4c4a-941a-4ac6e60c4648

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Date deposited: 12 May 2016 10:58
Last modified: 09 Jan 2018 18:08

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