Evaluation of primary caesarean section and neonatal outcomes in a tertiary care hospital and impact on current obstetric practice

Chugh, Amey; Lal, Swati; Nijhawan, Tanvi; Biradar, Pooja

doi:10.1016/j.eurox.2023.100213

Cited by 2 publications

References 10 publications

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Assessment of fetal resistance to hypoxia using the Stange test as an adjunct to Apgar scale assessment of neonatal health status

Shabanov,

Urakov,

Urakova

2023

Medical academic journal

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It has been established that the cause of biological death of fetuses in stillbirths and the cause of neonatal encephalopathies in live births is hypoxic brain cell damage in fetuses. Timely cesarean section remains the most effective way to preserve fetal life and health in the face of lethal intrauterine hypoxia. However, there is no universally recognized methodology for assessing fetal adaptation reserves to hypoxia and no methodology for selecting the type of delivery in order to perform a timely cesarean section if necessary. The Apgar score, which has been used since 1952, allows assessment of neonatal health at 1 and 5 minutes after birth, but this assessment is made without taking into account the health of the fetus before delivery. In recent years, it has been established that the outcome of fetal hypoxia is determined not only by its duration, but also by the amount of adaptive reserves available in the fetus to hypoxia. It was found that the duration of fetal immobility during apnea of a pregnant woman is an indicator of fetal resistance to hypoxia. In 2011, a method of assessing fetal resistance to intrauterine hypoxia based on the Stange test was developed in Russia. It has been found that the maximum duration of fetal immobility during maternal apnea is normally more than 30 seconds, while in the presence of fetal signs of fetoplacental insufficiency it does not reach 30 seconds, and in the presence of signs of severe fetoplacental insufficiency it does not reach 10 seconds. Therefore, it was proposed to consider good fetal resistance to hypoxia as an indication for vaginal delivery, and poor fetal resistance to hypoxia as an indication for cesarean section. A technique for assessing fetal resistance to hypoxia is described that has been developed for independent use by every pregnant woman. It is shown that it is sufficient for her to have a stopwatch and to be able to record the maximum period of fetal immobility during voluntary apnea. It is hoped that a measure of fetal resistance to hypoxia could be a meaningful complement to the Apgar score of neonatal health. It is envisioned that the use of a modified Stange test could help physicians prevent stillbirths and neonatal encephalopathies.

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Assessment of fetal resistance to hypoxia using the Stange test as an adjunct to Apgar scale assessment of neonatal health status

Shabanov,

Urakov,

Urakova

2023

Medical academic journal

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Prevalence and factors associated with admission to the neonatal intensive care unit at Gulu regional referral hospital

Oilo,

Omara,

Obol

et al. 2024

Preprint

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Background Globally, neonatal intensive care unit (NICU) admissions are a global concern, particularly in regions like sub-Saharan Africa. This study explored the prevalence and factors associated with NICU admission at Gulu regional referral hospital GRRH in northern Uganda. Method This was a cross-sectional study that employed quantitative techniques. Data were retrospectively collected from 576 randomly selected hospital records on NICU admissions from 1st July 2022 to 30th June 2023. All data were analysed using SPSS 25.0 statistical software. Descriptive and logistic regression analyses examined factors associated with NICU admission. Results Of the 576 records reviewed, there were111 (19.3%) neonates were admitted to the neonatal intensive care. Factors associated with admission of neonates to the neonatal intensive care unit were caesarean delivery, aOR: 3.82, 95% CI (2.17–6.72), preterm labour, aOR: 4.22, 95% CI (1.18–15.13), premature rupture of membranes, aOR: 11.16, 95% CI (5.79–21.49), and malaria in pregnancy, aOR: 4.37, 95% CI (1.53–12.53). Conclusion The rate of NICU admission at Gulu regional referral hospital was high. The factors associated with the admission of neonates to the neonatal intensive care unit at Gulu regional referral hospital were malaria in pregnancy, premature rupture of membranes, preterm labour and caesarean section.

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Evaluation of primary caesarean section and neonatal outcomes in a tertiary care hospital and impact on current obstetric practice

Cited by 2 publications

References 10 publications

Assessment of fetal resistance to hypoxia using the Stange test as an adjunct to Apgar scale assessment of neonatal health status

Assessment of fetal resistance to hypoxia using the Stange test as an adjunct to Apgar scale assessment of neonatal health status

Prevalence and factors associated with admission to the neonatal intensive care unit at Gulu regional referral hospital

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