To Study the
Effects of Shortening of Labour on Foetus
Chauhan P1, Baghel B2,
Dhruv VK3, Bansal
AK4 and Chauhan VKS4
Department of 1Obst. and Gynae.,
2Paediatrics, 3Anesthesiology, 4Community
Medicine, Govt. Medical College, Jagdalpur (Bastar).
ABSTRACT
In 97 % cases of study group no foetal
complication was observed in comparison to95 % in control group. Similarly only
1 % case develops neonatal Jaundice in study while in control group 3 % cases
develop neonatal jaundice. There was reduction in foetal
risk and foetal distress has been reduced
considerably.
Keywords: Foetal
Distress, Neonatal Jaundice.
INTRODUCTION:
Shortening of labour by Amniotomy and Pitocin is to be
carried out to ensure that every woman has sufficient uterine contractions in labour resulting delivery with in
24 hours, prolonged labour presents picture of mental
anguish and physical morbidity. It constitutes danger to the survival and
subsequent neurological development of the infants (Jaff
coate et al 1952).Amnitomy
and Oxytocin stimulation are accepted means to
achieve this O’Driscoll in 1969, showed that active
management can ensure this.
MATERIAL AND METHODS:
This study was conducted in Saltania
Zanava Hospital, Bhopal (M.P.). A sample size of 200
cases included in the study, out of 200 cases 100 were in study group and the
remaining 100 in control group.
To assess the effect of acceleration of labour on new borne, the child was examined in each case
soon after birth and its Apgar score noted down.
Numbers were given after one minute and 10 minutes respectively.
Apgar Score Chart: -
0 1 2
|
Heart Rate |
Absent |
Slow |
Above 100 |
|
Respiratory effort |
Absent |
Slow Irregular |
Good cry |
|
Muscular Tone |
Flaccid |
Some flexion |
Active |
|
Reflex irritability |
No Response |
Grimace |
Cry |
|
Colour |
Blue, Pale |
Body Pinkextrimities Blue |
Pink |
Basic were followed in purperium
for jaundice, fever, diarrhea and aspiration pneumonia etc.
Methods used for acceleration of labour
or active management of labour were amniotomy and pitocin
drip.
Amniotomy – it includes low rupture of the membrane. It was
carried out with ease and cleanliness Patient’s were prepared as for minor
operation. They were put in lithotomy position and
with aseptic precautions; the cervix was located with digital examination. A
finger was introduced through the canal so as to strip of the membrane from
lower sector. The membranes were ruptured with cocher’s
forceps where membranes were tense during uterine contractions, foetal heart sound were localized just after the amniotomy.
After
proper antiseptic pitocin drip was started in antecubital vein. The drip was commenced at 20 drops/
minute, which was equivalent to 0.05 unit/minute.
Efforts of shortening of labour
was noted on newborne
just after birth i.e. effect of Apgar Score and any
complication during the stay in the hospital. Thus the out
come of labour and side effects on new borne
were noted in both the group.
OBSERVATION AND
DISCUSSIONS:
On
analysis of the collected data it was revealed that 97 % the babies delivered
in study group were normal.
(Table
- I) There was one neonatal death. This baby had a big meningocele
over the occipital region. Baby was transfererred to
the Department of pediatrics and baby was expired on 3rd day. The
mother gave history of taking many abortificient
drugs during 1st and 2nd trimester of pregnancy. Only one
baby was asphyxciated as observed by apgar score. One baby had fever
due to cord sepsis. One baby had neonatal Jaundice which detected on 3rd
day and vanished after 4-5 days
TABLE – I: FOETAL COMPLICATIONS IN STUDY
GROUP
n=100
|
COMPLICATIONS |
NO. OF CASES |
PERCENTAGE |
|
No
Complications |
97 |
97
% |
|
Perinatal
Death |
01 |
1
% |
|
Pyrexia
(Due to cord sepsis) |
01 |
1
% |
|
Neonatal
Jaundice |
01 |
1
% |
|
Total |
100 |
100
% |
(Table
- II) in contrast to the study group, in control group 95 %babies were normal.
There were no perinatal deaths. One baby had pyrexia
due to cord sepsis. 3 babies had neonatal jaundice which appeared on 3rd
days and vanished after 5-6 days. There were one still birth, foetal heart sounds were not localized from the time of
admission and the mother was not feeling foetal
movements for the last 6-7 days.
TABLE – II: FOETAL COMPLICATIONS IN
CONTROL GROUP
n=100
|
COMPLICATIONS |
NO. OF CASES |
PERCENTAGE |
|
No
Complications |
95 |
95
% |
|
Neonatal
Death |
- |
- |
|
Pyrexia
(Due to cordsepsis) |
01 |
1
% |
|
Neonatal
Jaundice |
03 |
3
% |
|
Still
Birth |
01 |
1
% |
|
Total |
100 |
100
% |
Apgar score
was fair to good in all the cases. It was further noted by the author that the
because of shortening of labour foetal
distress has been considerably reduced. Kieran O’ Dviscoll
et al (1969, 1970) in his study of 1000 cases in primi
observed that there was neonatal death in second twin. First twin was presented
as breech. The second twin was delivered by forceps for found distress and died
with in minutes. Nacropay
showed sub serum patechial haemorrhage
and inhalation of me conium.
Bai and Mitra et al (1966) in a study of 500 cases found only one foetal deathduring labour and two neonatal deaths. One infant showed evidence
of residual brain damage to the central Nervous system. Baby suffered from
signs of cerebral irritation and motor seizures. The two neonatal deaths were
due to pre-maturity.
There
were no evidence of brain damage to the infants in the
present study of 200 cases, while one foetus showed
evidence of cerebral irritation and motor seizures in the study of 500 cases by
singh and Mishra. Kieran O’
Dviscoll et al
observed in their study of 1000 cases that one infant showed clinical evidence
of damage to centrality of foetal heart was detected,
but meconeum was present at delivery Aspyxiated was responded to Chdotracheal.
Condo
tracheal insufflations after five minutes but subsequently suffered from
cerebral irritation and another seizures. The discrepancies regarding these
findings of the present study and that of the other authors may be due to less
number of patients were included in the present study.
From
the above observations and discussions, the authors reached to the conclusion
that by acceleration of labour, mother’s discomfort
and foetal risk can be reduced and the mother’s
psychology x during labour can be improved (fear in
the mother mind about delivery and its out come )
resulting foetal distress has been considerably
reduced.
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Received on 17.03.2010
Accepted on 12.04.2010
© A &V Publication all right reserved
Research J. Science and Tech. 2(1):Jan. – Feb. 2010: 14-15