Accuracy of clinical diagnosis of fetal distress

Background: Fetal distress has significantly contributed to the rising caesarean section rate, which is as high as 20-25%. Caesarean section for clinically diagnosed fetal distress has been criticized as being unjustified in many instances. Objectives: To assess the fetal outcome in women delivered...

Full description

Bibliographic Details
Main Authors: Joseph I Ikechebelu, Gerald O Udigwe
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2004-01-01
Series:International Journal of Medicine and Health Development
Subjects:
Online Access:http://www.ijmhdev.com/article.asp?issn=2635-3695;year=2004;volume=9;issue=1;spage=12;epage=13;aulast=Ikechebelu;type=0
_version_ 1811313152378273792
author Joseph I Ikechebelu
Gerald O Udigwe
author_facet Joseph I Ikechebelu
Gerald O Udigwe
author_sort Joseph I Ikechebelu
collection DOAJ
description Background: Fetal distress has significantly contributed to the rising caesarean section rate, which is as high as 20-25%. Caesarean section for clinically diagnosed fetal distress has been criticized as being unjustified in many instances. Objectives: To assess the fetal outcome in women delivered by caesarean section following a clinical diagnosis of fetal distress and to determine the accuracy of this diagnosis. Methods: A retrospective analysis of the case notes of 126 parturients delivered by caesarean section for clinically diagnosed fetal distress at the University of Nigeria Teaching Hospital (UNTH) Enwga over a two-year period. Results: Forty six (36.5%) babies had Apgar scores of 7 and above, while 80(63.5%) had Apgar scores lower than 7, including 5 (4.0%) fresh stillbirths. The caesarean section rate in the hospital during the period covered by this study was 19.9% and fetal distress contributed 2.3% of this rate. The perinatal mortality rate was 39. 7 per 1000. Conclusion: Clinical diagnosis of fetal distress is accurate in about two-thirds of cases and wrong in the remaining one-third. Electronic fetal heart monitoring, fetal scalp blood sampling and fetal pulse oximetry should be provided by health care managers to improve diagnosis of fetal distress and minimize unnecessary caesarean sections. Though this study demonstrates the limitations of using clinical parameters alone in the diagnosis of fetal distress and in the selection of cases for caesarean section; however, in the absence of such modem facilities, clinical diagnosis is still useful, otherwise about two-thirds of such babies might perish.
first_indexed 2024-04-13T10:48:54Z
format Article
id doaj.art-44f9ac620b1b44fd9880258d516f1f17
institution Directory Open Access Journal
issn 2635-3695
language English
last_indexed 2024-04-13T10:48:54Z
publishDate 2004-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series International Journal of Medicine and Health Development
spelling doaj.art-44f9ac620b1b44fd9880258d516f1f172022-12-22T02:49:43ZengWolters Kluwer Medknow PublicationsInternational Journal of Medicine and Health Development2635-36952004-01-01911213Accuracy of clinical diagnosis of fetal distressJoseph I IkechebeluGerald O UdigweBackground: Fetal distress has significantly contributed to the rising caesarean section rate, which is as high as 20-25%. Caesarean section for clinically diagnosed fetal distress has been criticized as being unjustified in many instances. Objectives: To assess the fetal outcome in women delivered by caesarean section following a clinical diagnosis of fetal distress and to determine the accuracy of this diagnosis. Methods: A retrospective analysis of the case notes of 126 parturients delivered by caesarean section for clinically diagnosed fetal distress at the University of Nigeria Teaching Hospital (UNTH) Enwga over a two-year period. Results: Forty six (36.5%) babies had Apgar scores of 7 and above, while 80(63.5%) had Apgar scores lower than 7, including 5 (4.0%) fresh stillbirths. The caesarean section rate in the hospital during the period covered by this study was 19.9% and fetal distress contributed 2.3% of this rate. The perinatal mortality rate was 39. 7 per 1000. Conclusion: Clinical diagnosis of fetal distress is accurate in about two-thirds of cases and wrong in the remaining one-third. Electronic fetal heart monitoring, fetal scalp blood sampling and fetal pulse oximetry should be provided by health care managers to improve diagnosis of fetal distress and minimize unnecessary caesarean sections. Though this study demonstrates the limitations of using clinical parameters alone in the diagnosis of fetal distress and in the selection of cases for caesarean section; however, in the absence of such modem facilities, clinical diagnosis is still useful, otherwise about two-thirds of such babies might perish.http://www.ijmhdev.com/article.asp?issn=2635-3695;year=2004;volume=9;issue=1;spage=12;epage=13;aulast=Ikechebelu;type=0caesarean sectionfetal distressclinical diagnosis
spellingShingle Joseph I Ikechebelu
Gerald O Udigwe
Accuracy of clinical diagnosis of fetal distress
International Journal of Medicine and Health Development
caesarean section
fetal distress
clinical diagnosis
title Accuracy of clinical diagnosis of fetal distress
title_full Accuracy of clinical diagnosis of fetal distress
title_fullStr Accuracy of clinical diagnosis of fetal distress
title_full_unstemmed Accuracy of clinical diagnosis of fetal distress
title_short Accuracy of clinical diagnosis of fetal distress
title_sort accuracy of clinical diagnosis of fetal distress
topic caesarean section
fetal distress
clinical diagnosis
url http://www.ijmhdev.com/article.asp?issn=2635-3695;year=2004;volume=9;issue=1;spage=12;epage=13;aulast=Ikechebelu;type=0
work_keys_str_mv AT josephiikechebelu accuracyofclinicaldiagnosisoffetaldistress
AT geraldoudigwe accuracyofclinicaldiagnosisoffetaldistress