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

Abstract

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.

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

“…The study found that laboring mothers who were referred from nearby health facilities were more likely to develop NRFHRS. This finding is also identified in study conducted at Finote Selam (27).…”

“…This finding was higher than the studies found in Felege Hiwot Comprehensive specialized Hospital, 12.2% (34), Finote Selam General Hospital, 15.1% (27), Nigerian, 8.9% (11), and China, 11.5% (35). This may be due to more than half of participants were rural resident which might be referred from nearby facilities (34.3%), high proportion of nulliparity (39.6%), which further causes increased number of NRFHRS (10,35).…”

Obstructed labor and its effect on adverse maternal and fetal outcomes in Ethiopia: A systematic review and meta-analysis

“…Cesarean section due to obstructed labor. The meta-analysis of 17 [53,60,[72][73][74][75][76][77][78][79][80][81][82][83][84][85][86] studies showed the pooled prevalence of cesarean section due to OL in Ethiopia to be 17.67% (95% CI: 12.45, 22.89). A random-effects model of analysis was used due to a significant heterogeneity (I 2 = 98.8%, p-value < 0.01) (Fig 5).…”

“…A study from the Amhara region reported a 12.4% prevalence of neonatal sepsis among women with obstructed labor [95]. Similarly, two studies conducted in the Amhara region demonstrated a prevalence of neonatal near miss and non-reassuring fetal heart rate, 19.15% and 20%, respectively [52,53]. Association between obstructed labor and adverse maternal and fetal outcomes.…”

“…The prevalence of OL in Ethiopia is estimated at 20% [8], ranging between 3.3% and 34.3% in the Tigray [32] and Oromia regions [28], respectively. Incidence of adverse feto-maternal outcomes attributed to obstructed labor were reported in different studies: post-partum hemorrhage [34][35][36], obstetric fistula [37][38][39], sepsis [31,33] maternal near miss [40][41][42], hysterectomy [32,33] maternal mortality [42][43][44], perinatal asphyxia [45][46][47][48], perinatal mortality [49][50][51], neonatal near miss [52], non-reassuring fetal heart rate [53], and neonatal hypothermia [54].…”