Evaluation of Clinical Diagnosis of Fetal Distress and Perinatal Outcome in a Low Resource Nigerian Setting

Ajah, Leonard Ogbonna; Ibekwe, PC; Onu, Fidelis A.; Onwe, Ogah Emeka; Ezeonu, Thecla; Omeje, Innocent

doi:10.7860/jcdr/2016/17274.7687

Cited by 13 publications

(18 citation statements)

References 23 publications

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“…Mothers referred from other health facilities were nearly 3 times more likely to develop NRFHRP than mothers who were directly admitted to the hospital. This finding is also mentioned in another study [ 18 ]. The cause might be a delay in transportation.…”

Section: Discussionsupporting

confidence: 88%

Proportion and Associated Factors of Nonreassuring Fetal Heart Rate Patterns in Finote Selam Primary Hospital, North West Ethiopia

Kassahun

Aweke

Getu

et al. 2020

BioMed Research International

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Introduction. Nonreassuring fetal heart rate patterns (NRFHRP) suggest fetal conciliation or a deteriorating ability to handle the stress of labor. Nearly half of stillbirths occurring worldwide are due to hypoxia which is primarily manifested by NRFHRP. Hence, this study assessed the proportion and associated factors of NRFHRP in the Finote Selam primary hospital, North West Ethiopia. Methods. An institution-based retrospective cross-sectional study was conducted from March 1 to April 1, 2019, on 364 charts of mothers who gave birth from January 2017 to January 2018 at the Finote Selam primary hospital. A computer-based simple random sampling technique was used to select charts. A secondary data was collected using a structured questionnaire adapted from different literatures. The data was entered and analyzed using Epi Info version 7 and Statistical Package for the Social Sciences (SPSS) version 23.0. Binary logistic regression was executed, and all explanatory variables with p value < 0.2 were entered into multivariable logistic regressions. Multivariable logistic regression was used to control the effect of confounding variables and to identify factors affecting NRFHRP. Odds ratios with 95% confidence intervals were computed, and statistical significance was declared if p<0.05. Result. Out of 364 total deliveries, NRFHRP was detected on 55 (15.1%) fetuses, and the commonest NRFHRP detected was bradycardia 44 (80%). Most NRFHRP (38.18%) occurred on the deceleration phase of labor. There was no identified possible cause for NRFHRP on 34.5% of cases. Referral from nearby health institutions [AOR=2.832 (95% CI 1.457, 5.503)], primigravida [AOR=2.722 (95% CI 1.377, 5.381)], augmentation of labor [AOR=3.664 (95% CI 1.782, 7.534)], and meconium-stained amniotic fluid [AOR=6.491 (95% CI 3.198, 13.173)] were significantly associated with NRFHRP. Conclusion. The proportion of NRFHRP is high. Referral from nearby health institutions, primigravida mothers, augmentation of labor, and meconium-stained amniotic fluid were significantly associated with NRFHRP. Implementing a better referral link and close monitoring during follow-up could minimize NHFHRP.

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Section: Discussionsupporting

confidence: 88%

Proportion and Associated Factors of Nonreassuring Fetal Heart Rate Patterns in Finote Selam Primary Hospital, North West Ethiopia

Kassahun

Aweke

Getu

et al. 2020

BioMed Research International

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“…5,6 Other studies have also emphasised the importance of a 30-minute interval for safe neonatal outcomes. 7,8 However, there is currently little evidence that a DDI of ≤30 minutes is the norm in emergency CS cases. 9 In particular, achieving a DDI of ≤30 minutes in cases of fetal intolerance to labour can be very challenging.…”

Section: Application To Patient Care -In the Current Study It Was Fomentioning

confidence: 99%

Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases: Repeated cross-sectional study from Oman

Tashfeen

Patel

Hamdi

et al. 2017

SQUMJ

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abstract:Objectives: In cases of fetal intolerance to labour, meeting the standard decision-to-delivery time interval (DDI) of ≤30 minutes is challenging. This study aimed to assess DDIs in emergency Caesarean section (CS) cases to identify factors causing DDI delays and the impact of a delayed DDI on perinatal outcomes. Methods: This repeated cross-sectional study included all emergency CS procedures performed due to acute fetal distress, antepartum haemorrhage or umbilical cord prolapse at the Nizwa Hospital, Nizwa, Oman. Three audit cycles of three months each were conducted between April 2011 and June 2013, including an initial retrospective cycle and two prospective cycles following the implementation of improvement strategies to address factors causing DDI delays. Poor perinatal outcomes were defined as Apgar scores of <7 at five minutes, admission to the Special Care Baby Unit (SCBU) or a stillbirth. Results: In the initial cycle, a DDI of ≤30 minutes was achieved in 23.8% of 84 cases in comparison to 44.6% of 83 cases in the second cycle. In the third cycle, 60.8% of 79 women had a DDI of ≤30 minutes (P <0.001). No significant differences in perinatal outcomes for cases with a DDI of ≤30 minutes versus 31-60 minutes were observed; however, a DDI of >60 minutes was significantly associated with poor neonatal outcomes in terms of increased SCBU admissions and low Apgar scores (P <0.001 each). Factors causing DDI delays included obtaining consent for the CS procedure, a lack of operating theatre availability and moving patients to the operating theatre. Conclusion: The identification of factors causing DDI delays may provide opportunities to improve perinatal outcomes.

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“…The magnitude of NRFHRS in the world lies between 8.9% to 30.7%, which causes approximately half of all stillbirths (10,11) and there were an estimated 1.2 million stillbirths and 2.1million early neonatal deaths, among those 98% of these occurring in poor and middleincome countries, 77% in sub-Saharan Africa and south Asia (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

“…NRFHRS can leads to many health problems for newborn such as Hypoxia/anoxia, bad mood, frequent crying for a long duration, and intense crying (22), partial or total brain damage, cerebral palsy, paralysis, nerve damage (23), hearing and vision impairment, seizures, necrotizing enterocolitis, epilepsy, mental retardation, abnormal physical growth and perinatal death or stillbirth (15) and also increased risk of death of pediatrics through infection due to prolonged hospital stay (24). NRFHRS tracing was described as requiring necessitates immediate intervention like caesarean section or instrumental vaginal delivery (11,21), intrauterine resuscitation, including oxytocin deprivation and amnioinfusion (20) to prevent or reduce bad neonatal outcome. But determining the most effective strategy in the case of abnormal FHR tracings is so difficult.…”

Section: Introductionmentioning

confidence: 99%

Magnitude, Associated Factors and Immediate Outcomes of Non-Reassuring Fetal Heart Rate Status Among Laboring Mothers at South Gondar Zone Public Hospitals, North, West Ethiopia, 2022; Cross Sectional Study

Belete

Bazezew

Belay

et al. 2022

Preprint

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Background: Non-reassuring fetal heart rate status (NRFHRS) is an abnormal fetal heart rate monitoring which necessitates immediate intervention. It is one of the common reducible causes of perinatal morbidity and mortality in developing countries. Despite there is limited data on the magnitude, associated factors and its outcomes in Ethiopia. Objective : To assess the magnitude, associated factors and immediate outcomes of non-reassuring fetal heart rate status among laboring mothers at South Gondar zone public hospitals, northwest Ethiopia 2022. Methods: An institutional-based cross-sectional study was conducted from June 1-30, 2022. A total of 586 laboring mothers were included. The participants were selected through systematic sampling method. Bivariable and multivariable logistic regression analysis were carried out. OR with 95% CI was used and statistical significant variables were declare if p < 0.05 in multivariable analysis. Result: The magnitude of NRFHRS was 21.16% (95%, CI: 17.9-24.7) with a response rate of 97.34%. Primigravida [AOR= 1.86, 95% CI: 1.03-3.37], anemia [AOR= 4.59, 95% CI: 1.87-11.30], referred [AOR= 1.95, 95% CI: 1.07-3.55], induction of labor [AOR= 3.78, 95% CI: 1.20-11.9], meconium stained amniotic fluid [AOR= 14.13, 95% CI: 7.53-26.50], prolonged rupture of membrane [AOR= 11.70), 95% CI: 5.40-25.34] and low birth weight [AOR=5.08, 95% CI: 2.20-11.74] were significantly associated with NRFHRS. 4.8% of fetus was still birth. Conclusion : In this study the magnitude of NRFHRS was high compared to studies in Africa. Being primigravida, anemic, referred, induction of labor, meconium-stained amniotic fluid, prolonged rupture of membrane and low birth weight were significantly associated with NRFHRS. Assigning adequate number of midwifes for good labor follow-up, properly counsel on nutrition and iron and folic acid and give due attention on labor follow-up would minimize NRFHRS.

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Evaluation of Clinical Diagnosis of Fetal Distress and Perinatal Outcome in a Low Resource Nigerian Setting

Cited by 13 publications

References 23 publications

Proportion and Associated Factors of Nonreassuring Fetal Heart Rate Patterns in Finote Selam Primary Hospital, North West Ethiopia

Proportion and Associated Factors of Nonreassuring Fetal Heart Rate Patterns in Finote Selam Primary Hospital, North West Ethiopia

Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases: Repeated cross-sectional study from Oman

Magnitude, Associated Factors and Immediate Outcomes of Non-Reassuring Fetal Heart Rate Status Among Laboring Mothers at South Gondar Zone Public Hospitals, North, West Ethiopia, 2022; Cross Sectional Study

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