Cesarean delivery for suspected fetal distress among preterm parturients

Suneet P. Chauhan, Julie A. Mobley, Nancy W. Hendrix, Everett F. Magann, Lawrence D. Devoe, James N. Martin

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

OBJECTIVE: Among preterm parturients (< 37 weeks) who underwent cesarean delivery for suspected fetal distress, to determine the factors associated with decision-incision time (DIT) of ≤30 minutes and to assess if umbilical arterial pH < 7.10 is more common with DIT ≤ 30 or > 30 minutes. STUDY DESIGN: The peripartum course of all patients who had cesareans for suspected fetal distress over three years was reviewed. The inclusion criteria were reliable gestational age < 37 weeks and a single indication for cesarean delivery, suspected fetal distress. Twenty antepartum and intrapartum factors were used in a univariate analysis. RESULTS: The mean DIT among the 84 parturients was 30.5 ± 21.2 minutes, and 63% of patients had surgery started within 30 minutes. The incidence of pH < 7.10 was 20%. Multivariate analysis indicated that the two factors significantly associated with prolonged time to surgery were tachycardia with decreased variability (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.6-21.6) and use of spinal anesthesia (OR 6.2, 95% CI 1.1-35.0). Though none of the 20 variables had significant univariate associations with neonatal acidosis at α= .05, those with P < .20 were considered in multiple logistic regression analysis. None o/the 20 factors were associated with pH < 7.10, including DIT of ≥30 minutes (OR 0.26, 95% CI 0.06-1.03). CONCLUSION: DIT is likely to be > 30 minutes if cesarean delivery is due to decreased fetal heart variability or if spinal anesthesia is utilized; neonatal acidosis, however, is not significantly associated with a prolonged interval.

Original languageEnglish (US)
Pages (from-to)395-402
Number of pages8
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume45
Issue number5
StatePublished - Jun 22 2000
Externally publishedYes

Keywords

  • Cesarean section
  • Fetal distress
  • Labor complications

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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  • Cite this

    Chauhan, S. P., Mobley, J. A., Hendrix, N. W., Magann, E. F., Devoe, L. D., & Martin, J. N. (2000). Cesarean delivery for suspected fetal distress among preterm parturients. Journal of Reproductive Medicine for the Obstetrician and Gynecologist, 45(5), 395-402.