Retrospective analysis of the effect of electronic cardiotocography on selected birth and neonatal variables among 4172 women from a Single Centre in Warsaw, Poland.

Abstract

Objectives: Cardiotocography (KTG) is widely used for continuous or intermittent assessment of fetal heart function. This study aimed to compare the effects of continuous and intermittent KTG during labour on selected variables.

Material and methods: In a retrospective study, 4172 medical records of Warsaw Hospital (Poland) patients were analysed. The study group consisted of 2111 women with continuous KTG during labour and the control group of 2061 women with periodic KTG. The median age of the women was 30 years, and the median gestation period was 40 Hbd. Most of the women lived in urban areas (87.15%), were in a relationship (82.05%) and had a higher education (86.60%).

Results: In the group with intermittent OCT, delivery by caesarean section was indistinguishably more frequent (OR = 1.06; 95% CI = 0.87-1.30), there were significantly fewer grade II perineal ruptures (OR = 1.65, 95% CI = 1.07-2.55), grade III- and IV perineal ruptures (OR = 5.13, 95% CI = 1.12-23.53) and oxygen therapy (OR = 1.76, p = 0.004). More infants with Apgar scores ≤ 7 points at the fifth minute (OR = 0.34, 95% CI = 0.12-0.094), requiring nCPAP (Nasal Continuous Positive Airway Pressure) (OR = 0.56, 95% CI = 0.39-0.86) and resuscitation [OR = 0.37, 95% CI = 0.17-0.79]) were born in the group with periodic ECG. The analysis showed that the group of women with continuous OCT during labour had a lower risk of acid-base disorders (OR = 0.45, 95% CI = 0.21-0.98) CONCLUSIONS: Continuous KTG during labour in high-risk women increases the likelihood of instrumental delivery (using vacuum) and perineal incision compared with periodic KTG. The use of intermittent ECG during labour reduces the number of newborns with Apgar scores ≤ 7 points and decreases the number of neonatal interventions such as nCPAP and resuscitation.