Browsing by Author "Noraini binti Mohd Hanafi"

The aim of this study was to analyze the outcome of cases of foetal distress who had undergone caesarean section in relation to arterial blood gases, APGAR score and neonatal intensive care unit (NICU) admission. Diagnosis of foetal distress was based on CTG changes, meconium liquor or both. The significant predictor for NICU admission was also determined. This prospective study was conducted in Obstetrics and Gynaecological Department of Hospital Tengku Ampuan Afzan. Eighty-five women with singleton fetus who undergone caesarean section for foetal distress were taken as the study population. Eighty-five women who had emergency caesarean other than due to foetal distress were used as control. Women with known fetal complications or intrapartum problems were excluded from the study. A total of 8 newborns from the study group were admitted to NICU. There were three newborns with APGAR score < 7 at 1 minute and out of this only 1 require NICU admission for transient tachypnoeic of newborn and all had APGAR score ?7 at 5 minutes. Only the arterial pH was found to have significant relationship with foetal distress, (P-value 0.002) where by more than 66% (8 out of 12 newborn) of foetal distress neonates with pH ? 7.2 needed NICU admissions. Interestingly 85% of newborns of the foetal distress have normal pH. The arterial cord pH was also found to be a significant predictor of NICU admission, P-value 0.012. There was no adverse neonatal outcome in this study group. In conclusion, foetal distress based on CTG, meconium or both were not a reflection of poor neonatal outcome. It requires more than abnormal CTG to diagnose foetal distress in order to prevent unnecessary intervention and the subsequent related morbidities. The need of foetal scalp sampling is again emphasized.