DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20164651

Role of cardiotocography in high risk pregnancy and its correlation with increase cesarean section rate

Manisha Gupta, Punit Gupta

Abstract


Background: FHR monitoring plays the most important role in management of labouring patient when incidence of fetal hypoxia and progressive asphyxia increases. Now a day’s cardiotocography (CTG) become a popular method for monitoring of fetal wellbeing and it is assisting the obstetrician in making the decision on the mode of delivery to improve perinatal outcome. The aim of the study was to assess the effect of cardiotocography on perinatal outcome and its correlation with caesarean section rate.

Methods: In this prospective observational study 201 gravid women with high risk pregnancy in first stage of labour were taken. Result was assessed in the form of Apgar score at five minute, NICU admission, perinatal mortality and mode of delivery. Statistical analysis is done by using Chi square test and p<0.05 is considered as statistically significant.

Results: Perinatal morbidity in the form of NICU admission is higher in nonreactive group as compare to reactive group (75.7% v/s 22.8%). Cesarean section rate for fetal distress were higher in nonreactive group (87.8%) in comparison to reactive group (20.5%). So this study suggest that there is significant difference in mode of delivery with increasing chances of caesarean section in cases belong to non-reactive traces (p<0.001).

Conclusions: Admission test is non-invasive and the best screening test to evaluate the fetal health and to predict the perinatal outcome but it also associated with increase caesarean section rate.


Keywords


Admission test, Cardiotocography, Fetal distress, Perinatal outcome

Full Text:

PDF

References


Shedd JWW. Appropriate technology in intrapartum fetal surveillance in progress in O and G. Anilkumaran. S. Ingemarsson 1990; Edinburg, Churchill livingstone; p 127-140.

Admission CTG: A Rct Lancet. 2003;361(9356):465-70.

Penning S, Garite TJ. Management of fetal distress. Obset Gynecol Clin North Am. 1999;26(2):259-74.

Zuspan FP. Predictor of intrapartum fetal distress: The role of electronic fetal monitoring. Am Journal Obset Gynecol. 1979;135:287-91.

Ingermarsson I, Arulkumaran S, Ingermarsson E, Tambyaraja RL, Ratnam SS. Admission test: A screening tet for fetal distress in labour. Obstet Gynecol. 1986;68:800-906.

Royal college of obstetricians and gynaecologists 2001, the use of interpretation of cardiotocography in intrapartum fetal surveillance. Evidence based clinical guideline number 8.

Sood AK. Evaluation of Non-stress test in high risk pregnancy. J Obstet Gynecol. 2002;52:71-5.

Verma A, Shrimali L. Impact of admission non-stress test as a screening procedure on perinatal outcome. IJMPS. 2012;3(5):06-10.

Manning FA, Harman CR, Morrison I, Menticoglou SM, Lange IR, Johnson JM. Fetal assessment based on fetal biophysical profile scoring. IV. An analysis of perinatal morbidity and mortality. Am J Obstet Gynecol. 1990;162(3):703-9.

Sundhu GS, Raju R, Bhattacharyya Col KK, Shaktivardhan. Admission cardiotography screening of high risk obstetric patient. Medical Journal Armed Forces India. 2008;64:43-5.