Urgent Cesarean Delivery for Fetal Bradycardia

Abstract

II.

Effect of the interval between onset of sustained fetal bradycardia and cesarean delivery on long‐term neonatal neurologic prognosis

“…The present study found a significant negative correlation between BDI and UApH, which was inconsistent with the findings reported by Leung et al [2]. They found a significant correlation between BDI and UApH in pregnancies with intrapartum bradycardia due to irreversible causes, but not with reversible or unknown causes.…”

“…The difference in BDI range between the 2 studies could explain the inconsistency in these results. In the study by Leung et al [2], BDIs were all within 30 minutes, whereas in the present study, the BDI ranged from 11 to 47 minutes. Inclusion of transported cases in our study may have caused this difference.…”

“…However, limited information exists that correlates the timing of cesarean delivery with neonatal outcome, particularly the long-term neurologic prognosis. Leung et al [2] reported 235 urgent cesarean deliveries performed for intrapartum fetal bradycardia. In that study the BDI range was short at 14-18 minutes, and the neurologic outcome was favorable in all cases.…”

Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases: Repeated cross-sectional study from Oman

“…Ideally, the most valid immediate measures to determine perinatal outcome include the five-minute Apgar score, umbilical cord acid-base balance and the presence of neonatal encephalopathy; use of five-minute Apgar scores alone is a relatively restricted measure of fetal hypoxia. 7,18 Unfortunately, in the current study, perinatal outcomes were assessed by Apgar scores and SCBU admissions, as there were no facilities available to assess cord pH. In addition, the rate of neonatal convulsions could not be compared according to DDI category as data were not available for the 0-30 minutes and 31-60 minutes groups.…”

“…5,6 Other studies have also emphasised the importance of a 30-minute interval for safe neonatal outcomes. 7,8 However, there is currently little evidence that a DDI of ≤30 minutes is the norm in emergency CS cases. 9 In particular, achieving a DDI of ≤30 minutes in cases of fetal intolerance to labour can be very challenging.…”