Correlation of Cardiotocography with neonatal outcome in term pregnancies at a tertiary care centre in Bihar, India: A prospective observational study

Abstract

Early recognition of foetal distress by intrapartum cardiotocography (CTG) has a pivotal role in the improvement of perinatal outcome. So, the aim of this study was to correlate the findings of CTG with neonatal outcome.This Prospective Observational study was conducted on 300 pregnant women in labour having singleton term pregnancy with cephalic presentation. Intrapartum cardiotocography was done. CTG pattern was correlated with neonatal outcomes by analysing Apgar score, NICU admission and neonatal mortality rate. Statistical analysis was done by using chi square test and Fisher Exact test and p value < 0.05 was considered as statistically significant.Out of 300 patients, reactive CTG pattern was observed in 67% while suspicious and pathological pattern was observed in 22% and 11% of pregnancies respectively. The percentage of caesarean deliveries were significantly more among abnormal CTG group as compared to reactive group (p value < 0.0001). The sensitivity and specificity of CTG for predicting foetal distress and NICU admission was 80 % and 78.75% respectively. There was high NPV of 94.03%, and the diagnostic accuracy of test was 79%.Reactive CTG is more predictive of favourable neonatal outcomes while Pathological CTG tracing requires immediate intervention. Suspicious CTG requires close observation during intrapartum period after correcting underlying causes and taking conservative measures and Immediate delivery is not required unless it became pathological and hence caesarean section rate can be reduced in this group Overall, intrapartum CTG is an important screening tool for early identification of foetal distress.