Admission cardiotocography test: effect on neonatal outcome and obstetric intervention

ABSTRACT

The aim of this study is to compare the effect of admission cardiotocography [CTG] and Doppler auscultation of the fetal heart [FH] on neonatal outcome and obstetric intervention in a low risk obstetric population. It prospectively analysed 299 pregnant women who had no obstetric complications that warranted continuous monitoring of fetal heart rate [FHR] in labour. Women were given the choice either to receive CTG for 20 minutes or Doppler auscultation of the fetal heart when they were admitted in spontaneous uncomplicated labour. The outcome measures were umbilical arterial metabolic acidosis, other measures of neonatal condition at birth and obstetric intervention. There were no significant differences in the incidence of metabolic acidosis or any other measure of neonatal outcome among women who remained at low risk when they were admitted in labour. However, compared with women who received Doppler auscultation, women who had admission CTG were significantly more likely to have continuous FHR monitoring in labour, epidural analgesia, augmentation of labour, instrumental delivery and Caesarean section. Compared with Doppler auscultation of the FH, admission CTG does not benefit neonatal outcome in low risk women, and its use results in increased obstetric intervention