A study on cardiotocography for predicting fetal prognosis in high-risk pregnancy


  • Babita Kanwat Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
  • Megha Singhal Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
  • Madhubala Chauhan Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
  • Pallavi Chaubisa Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India






Background: The admission cardiotocography (CTG) in high-risk obstetrics patients for continuous monitoring of fetal heart rate (FHR) has become crucial in the modern obstetric practice. It is not only a good screening and inexpensive test but also non-invasive, easily performed and interpreted.

Methods: This was a prospective observational study conducted in department of obstetrics and gynaecology, Pannadhay Rajkiya Mahila Chikitsalaya at RNT medical college, Udaipur from April 2022 to September 2022. A total of 100 high risk obstetrics patients were subjected to cardiotocography (CTG). The Women eligible for the study were those who had gestational age ≥32 weeks with cephalic presentation in first stage of labour with singleton fetus in vertex presentation and categorised as high-risk during the time of admission.

Results: A total of 100 high risk obstetric patients were subjected to CTG. Out of these common high-risk factors in our study consisted of postdated pregnancy (21%) followed by pre-eclampsia (19%), oligohydramnios (16%) cord around neck (13%). Majority of them (47%) fall under 20-25 years and constituted by primigravida (59%).  CTG was reactive in (65%), non-reactive in 25% of cases and 10% patients had suspicious tracings. The incidence of neonatal intensive care unit (NICU) admission, fetal distress and APGAR score less than 7 was significantly higher with suspicious and nonreactive CTG than reactive CTG.

Conclusions: CTG test is a simple, non-invasive screening test should be used in high risk pregnancy as admission test. The heavy load of constant monitoring and adverse perinatal outcome can be reduced by CTG monitoring in high-risk obstetrics patients.


Joshi H, Panwar SM, Singh A. Role of admission test by cardiotocography (CTG) as a predictor of perinatal outcome: a prospective study. Int J Clin Contrac Obstetr Gynaecol. 2019;3(2):128-33.

Ware DJ, Devoe LD. The Nonstress test: reassessment of the “Gold standard.” 1994;21(4):779-96.

Bindu VK, Sajala VR, Sumagala devi. Abnormal fetal heart rate tracing pattern in patient with meconium stained amniotic fluid and its association with perinatal outcome. Int J Reproduct Contrac Obstetr Gynaecol. 2015;4(3):629-33.

Singh S, Premi HK, Gupta R. The Role of Non stress test as a method to evaluate the outcome of high-risk pregnancy: a tertiary care centre experience. Int Surg J. 2020;7(6):1782-7.

RCOG. Evidence based clinical Guideline number 8. the use of electronic fetal monitoring: The use and interpretation of cardiotocography in intrapartum foetal surveillance. London: RCOG press. 2001;52.

Ingemarsson I, Arulkumaran S, Ingemarsson E, Tambyraja RL, Ratnam SS. Admission test: a screening test for fetal distress in labour. Obstet Gynecol, 1986;68(6):800-6.

Blix E, Reine L M, Klovning A, Oian P. Prognostic value of the labour admission test and its effectiveness compared with auscultation only: A systematic review. BJOG. 2005;112(12):1595-604.

Freeman RK, Garite TH, Nageotte MP: Fetal heart rate monitoring. 3rd Ed; Lippincott Williams and Wilkins Philadelphia. 2003.

Das A. Admission cardiotocography: Forecasting perinatal outcome. Indian J Obstetr Gynecol Res. 2021;8(2):158-61.

Kumar A, Jaju PB. Admission test cardiotocography in labour as a predictor of fetal outcome in high risk pregnancy. Int J Reprod Contracept Obstet Gynecol. 2019;8(4):1331-6.

Garg S, Gupta A, Madhavan J. Non-stress test as an admission test to assess the outcome in high-risk pregnancy. Int J of Reprod, Contracept, Obstet and Gynecol. 2016;5(11):3993-4000.

Chaudhari KR, Pai SS. Admission test for screening labor. Hyderabad in: A comparative study by Dr. Reddy’s Laboratories. 2021;1.

Hegde A, Kore S, Srikrishna S, Ambiye VR, Vaidya PR. Admission test: screening test for prediction of fetal outcome in labour. Journal of obstet and gynecol of India. 2001;51(2):40-3.

Behuriya S, Nayak R. Admission cardiotocography as a screening test in high risk pregnancy and its correlation with perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3525-8.

Mires G, Williams F, Howie P. Randomised controlled trial of cardiotocography versus doppler auscultation of fetal heart at admission in labour in low risk obstetric population. British Med J. 2001;322(7300):1457-60.

Impey L, Reynolds M, MacQuillan K, Gates S, Murphy S, Shell O. Admission cardiotocography: A randomised controlled trial. Lancet. 2003;361465-70.

Nazir L, Lakhta G, Anees K, Khan FR, Safdar S, Nazir GR et al. Admission Cardiotocography as a Predictor of Low Apgar Score: An Observational, Cross-Sectional Study. Cureus. 2021;17;13(4):e14530.

Rahman H, Renjhen P, Dutta S, Kar S. Admission cardiotocography: its role, in predicting fetal outcome, in high-risk obstetric patients. Australasian Med J. 2012;5(10):522-7.

Lohana RU, Khatri M, Hariharan C. Correlation of NST with fetal outcome in term pregnancy (37 to 42 weeks). Int J Reproduct Contrac Obstetr Gynaecol. 2013;2(4):639-45.

Panda S, Das A, Nowroz HM, Singh AS. Role of Admission Tests in Predicting Perinatal Outcome: A Prospective Study. J Preg Child Health. 2015;2(171):2.

Sandhu GS, Raju R., Bhattacharya TK. Admission Cardiotocography Screening of High Risk Obstetric Patients. Medical J Armed Forces India. 2008;64(l):43-5.

Kushtagi P, Naragoni S. Labour admission test: an effective risk screening tool. J Indian Med Assoc. 2002;100(4):234-6.






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