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 language | English (US) |
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Pages (from-to) | 395-402 |
Number of pages | 8 |
Journal | Journal of Reproductive Medicine for the Obstetrician and Gynecologist |
Volume | 45 |
Issue number | 5 |
State | Published - Jun 22 2000 |
Externally published | Yes |
Keywords
- Cesarean section
- Fetal distress
- Labor complications
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynecology