Frequency of Adverse Perinatal Outcome in Women Undergoing Emergency Lower Segment Cesarean Section at Term Due To Non–Reassuring CTG at Tertiary Care Hospital

Abstract

Objective: To determine the frequency of adverse perinatal outcome in women undergoing emergency lower segment cesarean section at term due to non–reassuring CTG at Tertiary Care Hospital. Study Design: Descriptive case series-longitudinal. Study Setting: Study was conducted at Department of Gynaecology and Obstetrics, Aga Khan University Hospital. Duration of Study: Six months from 1st July, 2018 till 31st December 2018. Subjects and Methods: Data was prospectively collected from patients after taking a consent. A total of 211 patients were included. Demographic data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Post stratification chi square test was applied taking p-value of ≤ 0.05 as significant. Results: Mean age in group A and B was 33.56±3.91 and 34.71±4.01 years respectively. Adverse fetal outcome showed that birth weight < 2500 gm (20.4% vs 12.3%), APGAR score < 7 (16.6% vs 12.3%), Umblical cord ph < 7.1 (14.2% vs 9%), NICU admission (11.8% vs 8.5%) and still birth patients (4.3% vs 1.9%) who were in decision to delivery group of < 30 minutes and > 30 minutes respectively. Conclusion: This study showed that there are still avoidable delays in emergency caesarean section. Improving health care delivery so as to eliminate the identified causes would go a long way in reducing these delays. But given the results of this study, adverse fetal outcomes appears to be less in DDI > 30 minutes group when compared with DDI < 30 minutes group. Keywords: Elective lower segment cesarean section, decision to delivery time, birth weight, APGAR score, NICU admission, umbilical ph and still birth.