title: Clinical suspicion, management and outcome of intrapartum foetal distress in a public hospital with limited advanced foetal surveillance.
abstract: OBJECTIVE
  To determine the basis for the clinical suspicion of foetal distress, the instituted managements and delivery outcome in a tertiary hospital in sub-Saharan Africa with limited capability for advanced foetal monitoring.
  
  
  METHODS
  It is a 3-year retrospective analysis of all the obstetrics cases with intrapartum foetal distress.
  
  
  RESULTS
  There were 301 cases reviewed. The birth asphyxia incidence rate was 233/1000 live births and the perinatal death rate was 47/1000 live births. Suspicion of foetal distress was premised on the presence of persistent tachycardia or bradycardia during intermittent auscultation. Main resuscitative measures were left lateral repositioning of patient, fast saline infusion, intranasal oxygen administration and discontinuation of oxytocin infusion, if any. Only 124 (41.2%) of all the cases had delivery achieved within 2 h of diagnosis. Mean decision-delivery interval by caesarean section was 2.93 ± 2.05 h. Socio-demographic factors (p= 0.001) and pregnancy risk category (p = 0.002) influenced incidence of birth asphyxia.
  
  
  CONCLUSIONS
  To reduce subsisting high perinatal morbidity and mortality in sub-Saharan Africa, it is best that at the least referral hospitals should have advanced facilities for foetal monitoring and shortened surgical intervention time.
authors.affiliation: a Departments of Obstetrics and Gynaecology , Ekiti State University , Ado-Ekiti , Nigeria.
authors.forename: Abiodun Idowu
authors.initials: AI
authors.lastname: Adanikin
authors.affiliation: a Departments of Obstetrics and Gynaecology , Ekiti State University , Ado-Ekiti , Nigeria.
authors.forename: Jacob Olumuyiwa
authors.initials: JO
authors.lastname: Awoleke
mesh_terms: D000328:Adult; D001238:Asphyxia Neonatorum / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D005323:Fetal Monitoring; D006779:Hospitals, Public; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D016015:Logistic Models; D009549:Nigeria / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D012044:Regression Analysis; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: Asphyxia; electronic monitoring; intermittent auscultation; labour; sub-Saharan Africa