Rabindran, Gandhi
(2008)
Pathological CTG leading to emergency caesarean section and its perinatal outcome in Hospital Raja Perempuan Zainab II, Kota Bharu.
Masters thesis, Universiti Sains Malaysia.
Abstract
To evaluate the perinatal outcomes of infants who had pathological CTGs
resulting in emergency caesarean section as a mode of delivery. A cross sectional study was conducted from the 1st of June 2006 to 31st of
May 2007 in Hospital Raja Perempuan Zainab II , Kota Bharu. One hundred and forty
five patients who had pathological CTGs in labour had emergency caesarean sections.
The neonates were assessed in terms of their Apgar scores at 1 and 5 minutes of life
and had their umbilical artery pH recorded. The type of anaesthesia used, duration
between decision of caesarean section and delivery of neonates, appearance of liquor
and the variability of the CTGs were also recorded. In this study only 25 (17.25%) out of 145 neonates had an umbilical artery
pH ofless than 7.2. Out ofthe 145 neonates, only 21 (14.49%) had an Apgar score of
below 7 at 1 minute and only 1 (0.7%) neonate had an Apgar score of below 7 at 5
minutes of life. The mean umbilical artery pH was 7.26. Spinal anaesthesia was 3.4
times more commonly used than general anaesthesia. The mean duration between
decision of caesarean section and delivery was 59.9 minutes. The most common
variability seen was in the group of more than 25 which was 68 (46.9%), the
commonest liquor observed was clear in nature which was 71 (49%) in number, the
commonest baseline heart rate of 110-160 was seen in 116 (80%), the commonest
deceleration was late deceleration which was seen in 62 (42.8%) CTGs and
acceleration was absent in 129 (89%) CTGs. There was no association between the time taken between decision and delivery of
neonates with umbilical artery pH and Apgar scores at 1 and 5 minutes. There was an
association between the different groups of baseline heart rate, different types of
decelerations, different types of liquor and variabilities of the CTGs with umbilical
artery pH and Apgar scores at 1 and 5 minutes. There is also an association between
the presence and absence of acceleration with umbilical artery pH and Apgar score at
1 minute, but there was no association with Apgar score at 5 minutes. CTG alone is a poor predictor of fetal hypoxia in labour resulting in an
increase in caesarean sections.
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