Fetal outcomes in cesarean deliveries for non-reassuring fetal status at a Tertiary Hospital in western Kenya: A retrospective cross-sectional study

Abstract

Background: Non-reassuring fetal status (NRFS) encompasses feto-maternal conditions compromising fetal oxygenation, commonly  presents as abnormal fetal heart rhythm and meconium-stained liquor. It is a leading indicator of emergency cesarean sections. In 2021,  NRFS accounted for 36.03% of cesarean sections at Jaramogi Oginga Odinga Teaching and Referral Hospital. Owing to these numbers, we  did an in-depth evaluation of the fetal outcomes from emergency caesarian sections at this hospital. The outcome would provide  better knowledge base to guide decisions regarding optimal indications of emergency caesarian. 

Objective: To determine the fetal  outcome in cesarean deliveries for non-reassuring fetal status at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH).    

Methods: A retrospective cross-sectional study, from January, 2020 to December 2022. A total of 191 patients files were reviewed. Both  descriptive and inferential analyses were employed for analysis. 

Results: We found that in mothers who presented with NRFS, 59 (30.9%)  fetuses presented with tachycardia, 28 (14.7%) with bradycardia and 104 (54.4) had meconium-stained liquor (MSL). 51 (26.7%) were  taken to new born unit and 11 (5.8%) fetal demise, persistent fetal tachycardia contributed to 1 death, persistent fetal bradycardia 6  deaths or Meconium stain liquor 4 deaths. The rate of meconium-stained amniotic fluid deliveries in our study were 46 (14.66%) infants   had meconium grade three and 58 (30.83%) had meconium grade two. 

Conclusion: Mothers presenting with non-reassuring fetal heart and meconiumstained liquor had an increased risk of adverse fetal outcome.