Intact neurological survival after emergency caesarean delivery for pathological fetal heart rate tracings at term- is it time to rethink ‘fetal distress’ interpretation of cardiotocography in South African cerebral palsy lawsuits?
Date
2023-03
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Stellenbosch : Stellenbosch University,
Abstract
ENGLISH ABSTRACT: Objective: The aim of this descriptive study was to critically review the CTG tracings that informed the decision to do an urgent Caesarean delivery (CD) in cases where there was a good neonatal outcome. Method: This was an observational cross-sectional study using data collected from records at Tygerberg Academic Hospital reviewing women >36 weeks gestation who delivered by emergency caesarean section with the indication of “fetal distress” or “pathological CTG” and had normal neonatal outcomes. Results: The mean time from decision to do a CS to the delivery of the baby was 113 minutes and the mean time from the removal of the CTG from the patient (or the last CTG available to review in the folder) to the start of surgery was 46 minutes. The mean duration of abnormal tracings (from diagnosis to recovery or last CTG taken if there was ongoing abnormal CTG) was 72 minutes, ranging from 30 to 355 minutes. Eighty percent of women still had pathological changes on the CTG at the time of transport to theatre. Conclusion: This audit showed that in most babies with pathological CTG tracings, neither prolonged periods of abnormal tracing nor delays in delivery necessarily leads to a bad outcome. In litigation cases for term hypoxic brain injury, there are other underlying conditions of the fetus and mother that needs to be considered and not only a focus on CTG interpretation and management, before negligence is inferred.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (MMed) -- Stellenbosch University, 2023.