Neonatal outcome after caesarean birth for fetal distress and/or meconium staining in a South African rural setting.

The aim was to evaluate the effect of caesarean delivery on the neonatal outcome after labour with fetal distress and/or meconium staining (MS). We audited 199 caesarean sections performed for non-reassuring fetal condition (NRFC) and/or MS in a rural regional hospital. The 1 and 5 min Apgar scores were compared with those of 33 vaginal births after labour with MS. There were five neonates out of 232 (2.2%) with an Apgar score <7 at 5 min; one died early, neonatally. In the caesarean section group for NRFC, there were two fresh stillbirths and one early neonatal death, a perinatal mortality of 15.1/1,000 births. The 5 min Apgar score was not statistically significantly affected by the mode of delivery. Caesarean delivery does not improve the neonatal outcome when the amniotic fluid is meconium stained.