Predictive value of admission and intrapartum cardiotocography in normal and high risk antenatal women
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231532Keywords:
Admission CTG, Intrapartum CTG, Neonatal outcomeAbstract
Background: Cardiotocography is the most common method for assessing fetal health and reveals brain oxygenation. This study is done for admission and intrapartum cardiotocography in high- and low-risk pregnancies and its correlation with neonatal outcome.
Methods: All high-risk and normal antenatal women with more than 34 weeks of pregnancy and vertex presentation who came to the labor room were included in the study. 200 cases were taken, 100 were in the "high risk group," and the remaining 100 were in the "low risk group." On admission CTG and intrapartum CTG tracing were taken after written and informed consent, neonatal outcomes were observed, and adverse neonatal outcomes were noted.
Results: Admission CTG results were unsatisfactory for 9% of women in the high-risk group and none in the low-risk group. Intrapartum NST was non reassuring in 51% of high-risk women and 6% of the low-risk group. Of the total number of neonates admitted to the NICU, 14 were from the low-risk group, while 50 were from the high-risk group.
Conclusions: On admission NST in both low and high-risk women, the absence of category III NST predicted the absence of an adverse neonatal outcome most accurately. Even during labor in both high-risk and low-risk women, the absence of category III reassured the fetal well-being most precisely.
References
Whittle MJ, Martin WL. Fetal monitoring in labor. In: Chamberlain G, steer P, editors Turnbull's obstetrics: 2001;(1):439-50.
De Snoo K. Leerboek der Verloskunde (Text book of Obstetrics). Groningen: Wolters; 1946.
Bhartiya V, Sharma R, Kumar A, Srivastava H. Admission cardiotocography: a predictor of neonatal outcome. J Obstet Gynaecol Ind. 2016;66(Suppl 1):321-9.
Williams KP, Farquharson DF, Bebbington M, Dansereau J, Galerneau F, et al. Screening for fetal well-being in a high-risk pregnant population comparing the nonstress test with umbilical artery Doppler velocimetry: a randomized controlled clinical trial. Am J Obstet Gynecol. 2003;188(5):1366-71.
Gupta M, Nagar T, Gupta P. Role of cardiotocography to improve perinatal outcome in high risk pregnancy. IJCMR. 2017;4(4):853-6.
Prentice A, Lind T. Fetal heart rate monitoring during labour-too frequent intervention, too little benefit?. The Lancet. 1987;330(8572):1375-7.
Liston R, Sawchuck D, Young D. RETIRED: No. 197a-fetal health surveillance: antepartum consensus guideline. J Obstet Gynaecol Canada. 2018;40(4):e251-71.
Ayres-de-Campos D, Spong CY, Chandraharan E. FIGO consensus guidelines on intrapartum fetal monitoring: Cardiotocography. Inter J Gynecol Obstet. 2015;131(1):13-24.
Schifrin BS, Amsel J, Burdof G. The accuracy of auscultation detection of fetal cardiac deceleration: a computer simulation. Am J Obstet Gnaecol. 1992;166(2)6-76.
Faruqi M, Shrestha SC, Bhatta RD. Pregnancy outcomes of normal versus abnormal cardiotocography in a tertiary centre in Nepal. Int J Reprod Contracept Obstet Gynecol. 2019;8(11):4406-13.
Nandmer GK, Jaiswal S, Namdeo P. Comparative efficacy of admission cardiotocography in high risk and low risk pregnancies in predicting neonatal outcome. Int J Reprod Contracept Obstet Gynecol. 2021;10(10):3823-7.
Mires G, Williams F, Howie P. Randomised controlled trial of cardiotocography versus Doppler auscultation of the fetal heart at admission in labour in low risk obstetric population. BMJ. 2001;322(7300):1457-62.
Rajalekshmi M, Chithra J, Nithya R, Vijay N. Admission cardiotocography as a screening test to predict foetal outcome and mode of delivery. Indian J Obstet Gynecol Res. 2016;3(1):43-50.
Rahman H, Renjhen P, Dutta S. Reliability of admission cardiotocography for intrapartum monitoring in low resource setting. Niger Med J. 2012;53(3):145-9.
Shakira P, Haleema H. Effectiveness of Admission test. J Dow Univ Health Sci. 2007;1(1):205.
Bera S, Deb D, Ballov R, Chakraborty S. Efficacy of admission cardiotocography on neonatal outcome in term pregnancy admitted in labor in a rural-based tertiary care center: A prospective study. Asian J Med Sci. 2022;13(6):139-44.
Ingemarsson I, Arulkumaran S, Ingemarsson E, Tambyraja RL, Ratnam SS. Admission test: A screening test for fetal distress in labor. Obstet Gynecol. 1986;68(6):800-6.
Kushtagi P, Shashibala N. Labor Admission test-an effective risk screening tool. J Indian Med Assoc. 2002;100(4):234-6.
Ducey J, Guzman E, Schulman H, Farmakedis G, Karmin I. Value of a screening fetal heart rate tracing in the latent phase of labor. J Reprod Med. 1990;35(9):899-900.
