Justification of caesarean section for fetal distress.

A study was done from May 1995 to February 1996 to evaluate the justification of caesareans for fetal distress by examining the circumstances leading to operative delivery for compromised fetus. Of the 1096 caesareans, 179 (16.33%) were for fetal distress. One hundred and seven (59.78%) were nulliparas and 127 (71%) came with the clinical features of fetal hypoxia. In 142 (79%) parturients at the time of c-section, cervical dilatation varied from 0-3 cm and in 144 (80%) the presenting part remained unengaged. The method most commonly employed to diagnose fetal distress was the external cardiotocography, used in 141 (79%) patients either alone or in combination with other options. Predictivity value of the parameters used to identify the fetuses at jeopardy was found to be more sensitive when used in combination. Neonatal outcome related poorly with the preoperative diagnosis if only one parameter was used. Poorest neonatal outcome was observed in the presence of thick particulate meconium. Great care should be exercised by the obstetricians while making a decision for caesarean for fetal distress so as to avoid unnecessary procedures and neonatal complications.