Association of Intrapartum Fetal Distress and Immediate Postpartum Foetal Acidemia: A Cross-Sectional Observational Study

Dr. Sushmitha Nalla, Dr. Kavyarani C, Dr. Rathnamma P

Abstract: Introduction: Asphyxia at birth is one of the leading perinatal causes of morbidity and mortality necessitating effective intrapartum monitoring of the fetus for its detection and prevention of neonatal acidemia. Abnormalities in cardiotocography (CTG) indicate fetal distress, which may progress to metabolic acidosis if not treated early. This study investigates the correlation between intrapartum fetal distress and postpartum fetal acidemia at early time, as measured by umbilical cord blood pH. Methodology: This cross - sectional observational study was conducted at RL Jalappa Hospital and Research Centre, Kolar. Pregnant women with cephalic presentation and gestation of more than 37 weeks were enrolled. Intrapartum fetal monitoring was performed by CTG, which was classified as normal, suspicious, or pathological. Neonates with pathological CTG were subjected to umbilical cord blood pH analysis, and pH <7.2 was considered to be indicative of acidemia. Neonatal outcomes information, including NICU admission and resuscitation needs, were extracted. Statistical analysis was done using SPSS, where p - value <0.05 was taken as significant. Results: Pathological CTG findings were strongly associated with lower umbilical cord blood pH (p=0.043), increased NICU admission (p=0.024), and adverse neonatal outcomes. The NICU admission rates was higher in male newborns (p=0.005). Fetal distress, resuscitation, and abnormal liquor characteristics were highly associated with NICU admission (p=0.002, p=0.004, p=0.000, respectively). Ventilated neonates or with complications such as sepsis and low birth weight were likely to need NICU (p=0.018). Conclusion: Abnormal CTG results have a strong association with neonatal acidemia and adverse outcomes. Early detection of fetal distress, timely intervention, and intensified fetal monitoring can potentially reduce neonatal morbidity and mortality rates.

Keywords: Birth asphyxia, fetal distress, cardiotocography, neonatal acidemia, NICU admission, umbilical cord blood pH