Fetal distress in term pregnancies

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Fetal Medicine

Background:

• Fetal distress is a critical concern in term deliveries.
• Accurate diagnosis is essential for timely intervention and improved neonatal outcomes.
• Existing diagnostic methods have limitations in predicting neonatal morbidity.

Purpose of the Study:

• To evaluate the diagnostic utility of fetal scalp pH in identifying fetal distress.
• To assess the correlation between fetal distress, Apgar scores, and neonatal neurological status.
• To investigate the incidence of neurological abnormalities in term infants with suspected fetal distress.

Main Methods:

• Retrospective analysis of 75 term deliveries diagnosed with fetal distress from 3,972 total term deliveries.
• Inclusion of fetal scalp pH measurements in a subset of patients (27).
• Assessment of 5-minute Apgar scores and neurological follow-up to at least one month of age.

Main Results:

• Fetal scalp pH modestly improved the accuracy of fetal distress diagnosis.
• Twenty-three percent of infants had a 5-minute Apgar score of 6 or less.
• Six infants exhibited neurological abnormalities; five showed evidence of chronic and perinatal asphyxia.

Conclusions:

• Fetal scalp pH offers a modest improvement in diagnosing fetal distress.
• A significant proportion of infants diagnosed with fetal distress experienced adverse neurological outcomes.
• The study highlights the complexity of diagnosing fetal distress and its impact on neonatal neurology.