Evaluation of PH and APGAR score of neonates born by cesarean section due to the fetal distress

Over the past few decades, the prevalence of cesarean delivery has increased significantly worldwide. According to the World Health Organization, a cesarean section with the rate of 15% is accepted. The nonstress test (NST) is a method, monitoring the fetal health and providing data on the proper time for ending the pregnancy in emergent situations; however, sometimes it is not very accurate to diagnose hypoxia leading to unnecessary cesarean delivery.

In this analytical cross-sectional study, all 139 neonates with an impaired NST were enrolled. In addition to information such as 1st and 5th minute APGAR scores and umbilical cord pH, the demographic data of mothers and neonates were gathered.

In total, 252 impaired NST patterns were found in all studied neonates. Bradycardia and late decelerations had a significant relationship with acidosis. Moreover, late decelerations were associated with lower APGAR scores. Umbilical artery pH was significantly correlated with 1-minute (r=0.34; P=0.001) and 5-minute APGAR scores (r=0.32; P=0.001). Positive predictive value of NST was 48.9%.

The results showed that NST had a moderate positive predictive value for the diagnosis of fetal acidosis in neonates with tachycardia or non-reactive NST. It is needed to perform a prolonged NST to avoid an unnecessary cesarean delivery. Because of the correlation between disturbances in the 5-minute APGAR score and pH, with late deceleration, it should be seriously considered.