A study of fetal outcome in all fetal distress cases in labour.

Thesis Report.

ABSTRACT: OBJECTIVE: The purpose of this study was to correlate the intrapartum signs of fetal distress (FD) with the neonatal outcomes and to find any additional information leading to fetal distress. STUDY DESIGN: This was hospital based prospective cross-sectional descriptive study. Single full term pregnant women with vertex presentation in labour with the signs of fetal distress were studied. Fetal distress was diagnosed by intermittent auscultation for marked variation of the fetal heart rate, and assessing the colour of the amniotic fluid stained by meconium. RESULTS: A total of 200 cases of fetal distress were collected from 1939 deliveries during the study (45) days. There were 198 live births, 2 fresh still births, and 6 NNDs. The perinatal mortality rate was 40 per 1000 births. There were 80 cases who delivered by CS, 11 cases of forceps delivery, 50 cases of vacuum delivery, and 59 cases of spontaneous vaginal delivery. Fetal bradycardia with thick MSL had the worse neonatal outcome. There were 4 out of 6 NNDs and 2 SB who had fetal bradycardia with thick MSL. Fetal bradycardia with thick MSL was also found in 7 out of 12 cases with aspiration was 33.3% (2 out of 6 cases). Two other NNDs were one due to septicaemia and one due to congentital abnormality. Of the 27 cases with clear liquor who had FD, 12 cases had tight nuchal cord which could have contributed to FD. CONCLUSIONS: 1) This study showed that there was a significant mortality and morbidity associated with thick meconium stainec liquor. Therefore thick meconium stained liquor should be taken as a sign of fetal distress. 2) A tight nuchal cord may contribute to fetal distress.