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Titre du Document
Cesarean section for suspected fetal distress: Does the decision-incision time make a difference ?
Auteur(s)
CHAUHAN S. P. ; ROACH H. ; NAEF R. W. ; ...
Résumé
OBJECTIVE: To compare perinatal outcomes in patients at term (37 weeks) in whom the decision-incision time for cesarean delivery was due to suspected fetal distress. STUDY DESIGN: All parturients who underwent cesarean delivery primarily for possible fetal distress during a three-year period were identified retrospectively. Student's t test and the X2 test were utilized, and P<.05 was considered significant. A regression analysis of decision-incision time i and umbilical arterial pH was performed. RESULTS: From 1991 to 1993, 1.3% (117/9,137) of term laboring patients underwent emergency cesarean delivery for the primary indication of possible fetal distress. In 61 patients (52%) the decision-incision time was 30 minutes, while it exceeded 30 minutes in the remaining 56 women. The two patient groups were similar in maternal demographics, antepartum complications, oxytocin usage, thick meconium, types ofabnormal fetal heart rate tracing prompting surgery, use of amnioinfusion (41% vs. 36%), general anesthesia (97% vs. 93%), mean birth weight and Apgar score < 7 at five minutes. Three adverse outcomes were observed more frequently in association with decision-incision time > 30 minutes: (1) lower mean (± SD) umbilical arterial pH (7.16 ± 0.15 vs. 7.26± 0.06, P=.001), (2) pH < 7.00 (8/61 vs. 0/56, P=.005), and (3) admission to the neonatal intensive care unit (P=.008). When the incision was made longer than 30 minutes after the decision, there was no apparent adver
Editeur
Science
Identifiant
PMID : 9219122 ISSN : 0024-7758 CODEN : JRPMAP
Source
Journal of reproductive medicine A. 1997, vol. 42, n° 6, pp. 347-352 [bibl. : 15 ref.]
Langue
Anglais
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