Role of admission cardiotocography in predicting the obstetric outcome in term antenatal women: A prospective observational study.

Abstract

Background: Admission cardiotocography (CTG) used for fetal heart rate monitoring is an easy, cost-effective, non-invasive screening method for fetal well-being.

Objectives: To evaluate the role of admission CTG in predicting fetal hypoxia in term antenatal women during labour ward admission and to correlate the results with perinatal and maternal outcomes.

Material and methods: The present prospective observational study was conducted in the Obstetrics and Gynecology Department of the rural tertiary centre in Northern India over one year on 100 term antenatal women admitted to the labour ward in the first stage of labour. Participants were subjected to admission CTG for 20 minutes, and the pattern of fetal heart rate (reactive, suspicious, ominous) was recorded. Perinatal and maternal outcomes were assessed based on the fetal heart rate pattern on the admission CTG.

Results: Of 100 term antenatal women, 51 were low-risk and 49 were high-risk cases. In the low-risk group, 92.16% had reactive traces, 3.92% suspicious and 3.92% ominous traces on admission CTG, whereas, in the high-risk group, 40.81% had reactive, 32.65% suspicious and 26.54% ominous tracing (p < 0.0001). The most common mode of delivery in both groups with ominous tracing was cesarean section (p = 0.0001). Abnormal CTG was significantly associated with adverse perinatal outcomes including poor one-minute Apgar scores (p < 0.05), need for resuscitation and NICU admission (p < 0.05). The specificity and negative predictive value of admission CTG in low- and high-risk groups were 97.9% and 93.6%, and 85.0% and 85.0%, respectively.

Conclusion: Admission CTG is an effective, inexpensive, non-invasive technique to detect fetal hypoxia in low-and high-risk pregnancies in developing countries with an increased workload.