Urgent Cesarean Delivery for Fetal Bradycardia
Abstract
OBJECTIVE: To estimate whether fetal bradycardia-to-delivery interval or decision-to-delivery interval was related to cord arterial pH according to different causes of fetal distress. METHODS: Women who delivered singleton neonates by urgent cesarean delivery because of intrapartum fetal bradycardia were retrospectively categorized into three groups according to the cause of fetal bradycardia: 1) Irreversible; 2) Potentially Reversible; and 3) Unknown (no identifiable cause). Comparisons were made between groups in regard to pH, bradycardia-to-delivery interval, and decision-to-delivery interval. Correlation analyses between pH and both intervals were then performed for different groups. RESULTS: Of 235 cases, 39, 22, and 174 were respectively categorized into the Irreversible group, Potentially Reversible group, and Unknown group. The median pH was lower in the Irreversible group (7.094; interquartile range [IQR] 6.991-7.216) than in Potentially Reversible group (7.162; IQR 7.064-7.251) or Unknown group (7.210; IQR 7.161-7.255) (P<.001). The Irreversible group's median bradycardia-to-delivery interval was 5 minutes shorter than those of the other two groups (11 compared with 16.5 and 16 minutes, respectively; P<.001), whereas its median decision-to-delivery interval was 1 minute shorter (10 compared with 11.5 and 11 minutes, respectively; P=.001). In the Irreversible group, pH decreased with the bradycardia-to-delivery interval (Spearman's rho=-0.354; P=.027) at a rate of 0.011 per minute. Cord arterial pH did not correlate with the bradycardia-to-delivery interval in the Potentially Reversible and Unknown groups. In neither group did pH correlate with decision-to-delivery interval. CONCLUSION: Cord arterial pH deteriorates with bradycardia-to-delivery interval when the underlying cause of fetal distress is irreversible, but not so otherwise. LEVEL OF EVIDENCE: II.
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Quick delivery with a short bradycardia-to-delivery interval reduces the chance of severe acidosis.
“first, quick delivery with a short bradycardia‐to‐delivery interval reduces the chance of severe acidosis.”
From Neonatal outcome of infants with umbilical cord arterial <scp>pH</scp> less than 7 (2023) · cites this paper as [6]
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Self-citation
- Authors
- Leung, T. Y., Chung, P. W., Rogers, M. S., Sahota, D. S., Lao, T. T.-H., & Hung Chung, T. K.
- Affiliations
- Chinese University of Hong Kong (HK)
- Venue
- Obstetrics & Gynecology
- Published
- 2009-11
- Volume
- 114
- Issue
- 5
- Pages
- 1023-1028
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W2060320905
- Cited by
- 73
- References
- 23
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 6 · 2021: 5 · 2020: 5 · 2019: 1 · 2017: 5 · 2016: 2 · 2015: 2 · 2014: 8 · 2013: 4 · 2012: 7
- FWCI
- 7.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- fetal bradycardia, intrapartum fetal distress, decision-to-delivery interval, neonatal acid-base status
- MeSH terms
- Adult, Bradycardia, Cesarean Section, Emergency Treatment, Female, Fetal Blood, Fetal Diseases, Fetal Distress, Humans, Hydrogen-Ion Concentration, Pregnancy, Retrospective Studies, Time Factors, Umbilical Arteries
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