Assessment of early perinatal outcome of cases for whom cesarean delivery is done for clinical diagnosis of non-reassuring fetal heart rate pattern in Jimma University Specialized Hospital, Southwest Ethiopia

Abstract

Background: NRFHRP is one of the most common indications for cesarean delivery yet most of fetus have good outcome in most of study‘s. Objective: To determine early perinatal outcome and associated factors with the clinical diagnosis of NRFHRP Design: A hospital based prospective, cohort study. Setting: Jimma University specialized hospital. Subjects: 59 pregnant women with clinical diagnosis of NRFHRP for whom cesarean section is done compared with 59 pregnant women without the diagnosis of NRFHRP for whom cesarean section is done. Result: Low APGAR score at 1st minute is noted 64.4% newborn with clinical diagnosis of NRFHRP compared with 22% without clinical diagnosis of NRFHRP. The risk of having low 1st minute APGAR score in newborn with clinical diagnosis of NRFHRP is 2.7*that of new born without NRFHRP.The adjusted RR after correcting for confounder is (ARR=2.72, 95% CI=1.64-4.44, P=0.0001). Similarly low 5th minute APGAR score is noted in 25.4% newborn with clinical diagnosis of NRFHRP as compare to only 3.4% of new born without clinical diagnosis of NRFHRP. So the risk of having low 5th minute APGAR score in new born with clinical diagnosis of NRFHRP is 6.9*higher than those without NRFHRP. (ARR=6.9, 95%CI=1.66-29.41, P=0.008). 42.4%of newborn with clinical diagnosis NRFHRP are admitted to NICU and treated while only 22.01% of those without NRFHRP. So newborn with clinical diagnosis of NRFHRP have 1.9* risk of admission to NICU than those without NRFHP. (RR=1.92, 95%CI=1.09-3.38, P=0.019). But after adjusting it for confounders the RR is 1.74 (RR=1.74, 95%CI=0.97-3.13, P=0.061). Conclusion: The result found in this study showed that clinical diagnosis of NRFHRP have strong risk of having low 1st and 5th minute APGAR score. So clinical diagnosis of NRFHRP is valuable in identifying fetus in need of expedited delivery.