Abnormal cardiotocographic findings and perinatal outcome: a prospective study

ABSTRACT

Background: CTG as an intrapartum fetal surveillance can be judged appropriately taking the abnormal features of CTG individually into account for decision making of early delivery to reduce the fetal and neonatal morbidity. Objectives of this study were to identify the fetuses at risk of developing hypoxia as evidenced by abnormal FHR pattern seen by CTG and to correlate the abnormal features with perinatal outcome and find out the most specific feature among all abnormal features of CTG in detecting the adverse perinatal outcome.Methods: This was an observational study where total of 249 uncomplicated pregnant patients in active labor were selected randomly and CTG were done for them. Progress of labor was recorded in partogram. Only pathological CTGs were considered for early decision of delivery by LSCS. After delivery Apgar score 1 min, 5 min, baby weight, colour of liquor, NICU admission and no of days of admission in NICU were recorded.Results: For liquor colour, variability and absence of acceleration were good screening heart rate features and baseline was considered the most specific feature. For all babies with poor Apgar score at 1 min, abnormal baseline was the most specific feature. For NICU admission, the abnormal baseline the most specific feature. Acceleration was found to be the most sensitive heart rate feature among all other heart rate features. Liquor colour had better sensitivity for detecting poor Apgar score at 1min and 5 min. There was increase rate of cesarean section and operative vaginal delivery.Conclusions: Abnormal intrapartum CTG features of an uncomplicated laboring mother >37 weeks can detect fetuses at distress with different specificities and sensitivities when considered individually and can reduce the perinatal morbidity.