Raidt, J.J. (2019) Antenatal and intrapartum risk factors for non-reassuring fetal status. thesis, Medicine.
Full text available on request.Abstract
Background: ‘Non-reassuring fetal status’ (NRFS) is a term used to describe suspected fetal hypoxia. Severe hypoxia can result in short- and long-term morbidity. This study aims to identify independent risk factors for developing NRFS. Methods: This is a prospective observational cohort study conducted in South-Australia between March 2015 and July 2018. All data was collected during regular pregnancy check-ups, additional questionnaires and case note reviews. A group of NRFS was defined by selecting all the women that met up with one or more of the following criteria: 1) five-minute Apgar score ≤7; 2) forceps, vacuum extraction or CS delivery for suspected ‘fetal distress’; 3) arterial cordblood pH ≤7.2 or if arterial samples were unavailable, venous cordblood pH ≤7.2 and/or 4) arterial lactate ≥4.8 or if arterial samples were unavailable, venous lactate ≥4.8. A total of 417 cases of NRFS were researched in comparison to 841 control cases. Variables included a comprehensive selection of antenatal, intrapartum and neonatal factors. Results: Epidural analgesia, oxytocin, induction of labour (IOL) and small for gestational age (SGA) all showed a correlation to developing NRFS (all p<0.05). Logistic regression analysis showed of the variables analysed, only epidural analgesia (RR 1.67, 95% CI 1.16-2.41) and IOL (RR 3.61, 95% CI 1.33-9.78) were significantly associated with NRFS. Conclusion: Epidural analgesia, oxytocin and IOL are all intrapartum risk factors associated with developing NRFS. Neonates born SGA are also more at risk. Awareness of the risk factors for developing NRFS, helps identifying fetuses at risk at an early stage, which allows physicians to optimise intrapartum surveillance and timely interventions to lower the incidence of both morbidity and mortality in these children.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Erwich, Prof. J.J.H.M. and Department of Obstetrics and Gynaecology, UMCG and The Netherlands |
| Supervisor name: | Dekker, Prof. G.A. and Academic Head, Department of Obstetrics & Gynaecology |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:48 |
| Last Modified: | 25 Jun 2020 10:48 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/938 |
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