Outcomes of Labour based on Cardiotocography Categories: Donabedian Model Approach

Abstract

Background : Many factors are crucial to be considered when determining labor outcomes and mode of giving births for pregnant women. The aim of the study: The current study aimed to investigate the correlation between cardiovascular imaging categories and determining the labor outcome based on Donabedian model approach.. Methodology: A correlational and descriptive study design was adopted in the labor room at maternal and children hospital (MCH) in Najran-Saudi Arabia. A purposive sampling technique was utilized for recruiting a total of 390 full term pregnant ladies at labor stag with specific inclusion criteria. A self-reported questionnaire, besides check-list was used for collecting data. Results: The age of the participants ranged between 18 and 41 years, with a mean of 26.2 ±6.1 years. Gravidity ranged between 1 and 7, with a mean of 2.7 ±3.1. Moreover, parity ranged between 1 and 8, with a mean of 1.9 ±1.8. The observed delivery mode was spontaneous normal vaginal delivery for 43.1%, followed by emergency cesarean section for 26.7%, while the least reported mode was vacuum-assisted (instrumental) vaginal birth for 9.2% of the participants. CTG was determined to be 86% for category I, 9% for category II, while category III was estimated for 5% respectively. Most of the newborns 362 (92.8%) had 7-10 Apgar scores in 1st minute, and almost 96% of them had 7-10 Apgar scores in the 5th minute. Only 7.2% (n=28) of newborns had been admitted to the neonatal intensive care unit (NICU). Mode of delivery, Apgar score at first minute, and admission to NICU were significantly associated with the CTG categories (P= 0.001, 0.045 & 0.012). Conclusion & recommendation : CTG categories were significantly related to labour outcomes in terms of mode of delivery, Apgar score at first minute, and thus NICU admission. For increasing CTG efficiency, continuous training is crucial for obstetricians and midwives on how to interpret CTGs and to escalate when there are concerns.