Maternal factors contributing to asphyxia neonatorum
The objective was to identify maternal risk factors for birth asphyxia, and took the form of a retrospective study over 3 years of 15,964 deliveries. The antenatal and intrapartum course of 68 mothers who delivered babies with birth asphyxia was studied. Babies < 34 weeks/≤ 2000 g at birth were excluded. A 5-min Apgar score < 6 was regarded as abnormal. The incidence of asphyxia neonatorum was 4.6/1000. Most mothers (76 per cent), resided locally, booked (91 per cent), and had satisfactory antenatal clinic attendance (average seven visits). The distribution showed a disproportionately large number of grand multiparas (10 per cent). Labour was characterized by prolonged first (49 per cent) and second (36 per cent) stages with a high incidence of meconium in the amniotic fluid (47 per cent). Most deliveries (53 per cent) were by caesarian section of which 44 per cent were performed for fetal distress. Meconium aspiration was common (34 per cent). High risk signs in labour can be recognized. The judicious use of the partogram, fetal scalp blood pH, and amino-infusion are encouraged.