Role of admission test by Cardiotocography (CTG) as a predictor of perinatal outcome: A prospective study

Abstract

Background: Routine and continuous electronic monitoring of foetal heart rate (FHR) in labour has become an established obstetric practice. In this study we aim to evaluate if the admission Cardiotocography (CTG) can be used as a predictor in detecting foetal hypoxia at the time of admission in labour and to correlate the results of the admission CTG with the perinatal outcome. Material & Method: Total of 100 patients admitted in the labour room with singleton live pregnancy after 37 weeks of gestation were included in this prospective observational study. Foetal heart tracing was recorded at the time of admission to labor room, for a period of 20 minutes and evaluated using standard procedure. Result: One hundred patients were recruited. The admission CTG were 'reactive' in 67, equivocal in 21, and 'ominous' in 12 women. Occurrence of foetal distress, meconium stained liquor and neonatal intensive care unit (NICU) admission was significantly more frequent among patients with ominous test results compared with equivocal or reactive test results on admission. Incidence of vaginal delivery was more common when the test was reactive. Conclusion:It is simple and easy test and an effective screening test to identify group of women with greater risk of Intrapartum foetal hypoxia and prevents unnecessary delay in intervention.

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

“…This result was comparable to a study conducted by Joshi H et al 3 In the study conducted by Thapa et al, 27.4% patients with reactive CTG had caesarean delivery, while 75% patients with non-reactive CTG underwent caesarean section. 10 Banu S et al in their study on 100 pregnant women found that percentage of various mode of delivery among suspicious and pathological CTG group did not show significant difference with p value 0.663, which was similar to our study.…”

“…Similarly, Joshi H et al conducted a study on 100 pregnant women and showed that CTG was reactive in 67%, suspicious in 21% and pathological in 12% of women. 3 Dhakare J. T et al conducted a study on 105 high risk pregnant patients and showed that incidence of the reactive trace was 62.9%, while suspicious and pathological patterns were observed in 13.3% and 23.8% respectively. 8 Out of 201 patients with reactive CTG, 135 patients (67.16%) delivered vaginally, 6(2.99%) patients underwent instrumental vaginal delivery while 60 (29.85%) patients were delivered by caesarean section.…”

“…1,2 However FHR changes, foetal hypoxia and acidosis may occur with same frequency in low-risk patients as in high risk one. 3 Interpretation of the cardiotocography includes the description of frequency, intensity and duration of uterine contractions, baseline foetal heart rate, baseline foetal heart rate variability, presence of accelerations, periodic or episodic decelerations and accordingly cardiotocography will be normal, suspicious or pathological. 4 Studies indicate that number of stillbirths and early neonatal deaths are higher among nonreactive CTG group as compared to reactive group.…”

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“…Hasil penelitian ini sejalan dengan penelitian yang telah dilakukan oleh Joshi et al pada tahun 2019 dimana hasil CTG menentukan metode persalinan yang akan dilakukan. 11 Tabel 4 dapat dijelaskan hubungan antara kategori kardiotokografi dengan asfiksia. Dalam hal ini yang dimaksud asfiksia berat sesuai definisi operasional yaitu didapatkan Apgar score pada menit kelima ≤3.…”

A study on cardiotocography for predicting fetal prognosis in high-risk pregnancy

“…Journey of the fetus through the birth canal is a stressful response which can be manifested by the fetus as a "stress response" in the form of fatal heart rate abnormity. 1 Fetal surveillance during labour is important to ensure delivery of a healthy baby. Cardiotocography (CTG) is a continuous recording of the fetal heart rate (FHR) which is used in early labour to detect such compromise fetus in labour wards.…”