The Success of Cardiotocography in predicting Perinatal Outcome

Kaban, Alpaslan; Cengiz, Hüseyin; Kaban, İşık; Özcan, Alim; Karakaş, Sema

doi:10.5799/ahinjs.01.2012.02.0137

Cited by 3 publications

(6 citation statements)

References 12 publications

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“…18.3% of the neonates had acidosis which is comparable to the studies by Kaban 4 et al (13.26%) and Modarressnejad V (20.25%). 4,7 In the study by Aboulghar W et al, incidence of acidosis was higher, with 34% of babies having abnormal cord blood pH. This higher value of acidosis in the neonates could be explained by the fact that their study included only those women who had undergone caesarean section for pathological and suspicious CTG, while in the other studies mentioned above and in our study, consecutive term labouring women were included.…”

Section: Discussionmentioning

confidence: 54%

“…Findings of the present study are also comparable to study by Kaban et al who studied 101 term pregnant women admitted for delivery. 4 In their study 85 neonates had normal cord arterial pH and 13 had fetal acidosis as diagnosed by cord arterial pH values <7.2. Of the 13 neonates with acidosis, 5 had non-reactive CTG tracings intrapartum.…”

Section: Discussionmentioning

confidence: 95%

“…This is comparable to several studies. [4][5][6][7] Kaban et al used the cut off value for defining acidosis as cord blood pH <7.2 in their study. 4 Modarressnejad V defined fetal acidosis as cord blood pH <7.1.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Kaban et al used the cut off value for defining acidosis as cord blood pH <7.2 in their study. 4 Modarressnejad V defined fetal acidosis as cord blood pH <7.1. 7 In the present study, an umbilical arterial cord blood pH of <7.2 at birth is taken as the cut-off value to define acidosis in the neonate.…”

Section: Discussionmentioning

confidence: 99%

“…The blood was delivered to the laboratory within 5 minutes. 4 Cord blood was analysed by Radiometer ABL 800 Basic Machine used in our institute. The umbilical cord arterial blood pH was used for assessing fetal acidosis.…”

Section: Cord Blood Collectionmentioning

confidence: 99%

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Intrapartum cardiotocography and its correlation with umbilical cord blood pH in term pregnancies: a prospective study

Ray

2017

Int J Reprod Contracept Obstet Gynecol

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Background: The purpose of intra-partum fetal monitoring is to identify early signs of developing hypoxia. Electronic fetal monitoring is performed using cardiotocograph, which is a paper record of the fetal heart rate (FHR) patterns plotted simultaneously in relation to uterine activity. In low resource settings umbilical cord artery blood gas analysis can provide important information about the foetuses exposed to intrapartum hypoxaemic events and can distinguish the infant at high risk for asphyxia and related sequelae. The aim of this study was to correlate intrapartum CTG findings with umbilical cord blood pH at birth in term pregnancies in labour and thus evaluate the success of CTG in predicting fetal acidosis during labour. Methods: The present study included 301 consecutive women with term singleton pregnancies in labour. Intrapartum CTG was taken and classified into normal (category I trace), indeterminate (category II trace) and abnormal (category III trace) according to NICHD 2008 Classification (Adapted by ACOG 2013). Umbilical cord arterial blood was taken immediately after birth, in a pre-heparinised syringe and sent to the laboratory for pH study to detect acidosis. Cord blood pH <7.2 was taken as acidosis and cord blood pH ≥7.2 was taken as normal. Results: In this study, 50.2% of the women had normal CTG, 36.5% had indeterminate CTG and 13.3% had abnormal CTG. 18.3 % of the babies had acidosis. Out of the subjects with abnormal intrapartum CTG, 52.5% had acidosis, of the subjects with normal intrapartum CTG trace, 7.3% had acidosis and of the 110 subjects with indeterminate intrapartum CTG, 22.7% had acidosis. A statistically significant association was found between intrapartum CTG and umbilical cord arterial pH (p <0.001). Conclusions: From the analysis of this study, it can be concluded that an abnormal CTG should be managed appropriately, without delay, in order to prevent acidosis in the neonate and adverse long-term sequelae. The obstetrician should be more vigilant in cases of indeterminate CTG tracings and monitor such labours closely.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Cord Blood Collectionmentioning

confidence: 99%

See 3 more Smart Citations

Intrapartum cardiotocography and its correlation with umbilical cord blood pH in term pregnancies: a prospective study

Ray

2017

Int J Reprod Contracept Obstet Gynecol

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Is fetal CTG a reliable indicator of fetal distress? A prospective study on relationship between CTG suspected fetal distress and immediate postpartum umbilical cord blood pH.

et al. 2022

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Introduction: Perinatal asphyxia is one of the major causes of neonatal morbidity and mortality. Fetal Cardiotocography (CTG) has been used for long to predict fetal asphyxia. Despite its popularity, it has not been proved to be an ideal tool for monitoring as, although a normal trace is indicative of a normal acid-base status at birth, in about 98% of cases, an abnormal trace has a low positive predictive value in term of fetal acidosis (pH less than 7.25) .An undisputed evidence of perinatal asphyxia is metabolic acidosis on arterial cord blood or very early neonatal samples: pH< 7 and base deficit >12 mmol/L Aim: To see the correlation between suspicious/pathological CTG and umbilical cord blood pH at birth in term pregnancies.Material and methods: This was a hospital based prospective randomized observational study over a period of 1 year. It was conducted on 165 pregnant women with singleton term pregnancy admitted to labour ward for delivery and having suspicious / pathological CTG trace or meconium stained liquor with normal CTG trace. Immediately after the birth of the neonate, umbilical cord was clamped, cut and umbilical artery cord blood was collected in a pre -heparinized syringe and sent for pH analysis. Cord blood pH of less than 7.2 was interpreted as acidosis.Results: The number of acidotic cases (as determined by cord blood pH less than 7.2) was 2(5.6%) in normal traces whereas 34 cases (94.4%) of normal traces were non acidotic. In the suspicious traces, 2 cases (3.2%) were acidotic and 59 cases (96.8%) were non acidotic. In the pathological category, 13 cases (19.1%) were acidotic and 55 cases (80.9%) were non acidotic. There was no significant association of CTG category with cord blood pH, acidosis, pO2 or pCo2 values but that with presence of MSL and grade of MSL was statistically significant.Conclusion: Abnormal CTG while being a good predictor of the presence of MSL and also the grade of MSL, is a poor predictor of the presence of fetal acidosis and neonatal status after birth. Fetal monitoring using cardiotocography was associated with considerable false positive results. Thus, using fetal heart rate abnormalities alone as a measure of diagnosis of fetal distress during labour is a contributing factor of increasing rate of cesarean sections.

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Analysis of Intrapartum Cardiotocography Findings in Labour, its Correlation with Umbilical Arterial Blood pH and Neonatal Outcome

Mushtaq,

Shrestha,

Ansari

et al. 2023

Medphoenix

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Background: Cardiotocography (CTG) is being used in all labouring women to detect intrapartum hypoxemia which further requires confirmatory tests. But in a setting where these facilities are not available, umbilical artery pH analysis can help not only in identifying neonates with intrapartum hypoxemia but can also help in anticipating neonatal adverse outcomes. The aim of the study was to analyse intrapartum cardiotocography and its correlation with umbilical artery pH and neonatal outcome. Methods: Total of 317 consecutive single, term, labouring women were included in the present study. After taking CTG, it was classified into normal, non-reassuring and abnormal groups according to National Institute of Clinical Excellence (NICE) guideline 2017. At birth umbilical cord arterial blood was taken to detect neonatal hypoxemia. At the same time, APGAR score at 5 minute of birth, NICU admission and neonatal mortality was also recorded. Neonates with umbilical artery blood pH of ≤7.2 were considered as asphyxiated. Results: Among 317 women 48.8% had normal CTG, 35% had non-reassuring and 15.4% had abnormal CTG. APGAR score was found to be <7 in 17.3%, and same number of neonates had NICU admission. Out of 113 non-reassuring CTG, 5.9% had acidosis. This number was much higher in abnormal CTG group where 11% had acidosis. There were 6 neonatal mortalities. A statistically significant association was found between intrapartum CTG and umbilical artery pH and neonatal outcomes. Conclusion: Cardiotocography is an effective screening tool that is routinely used in all labouring women for screening of fetal hypoxia. By doing that timely intervention can be under taken to avoid neonatal morbidity and mortality.

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The Success of Cardiotocography in predicting Perinatal Outcome

Cited by 3 publications

References 12 publications

Intrapartum cardiotocography and its correlation with umbilical cord blood pH in term pregnancies: a prospective study

Intrapartum cardiotocography and its correlation with umbilical cord blood pH in term pregnancies: a prospective study

Is fetal CTG a reliable indicator of fetal distress? A prospective study on relationship between CTG suspected fetal distress and immediate postpartum umbilical cord blood pH.

Analysis of Intrapartum Cardiotocography Findings in Labour, its Correlation with Umbilical Arterial Blood pH and Neonatal Outcome

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