Intrapartum fetal monitoring by cardiotocography and its correlation with labour outcome


  • Kanupriya Singh Department of Obstetrics and Gynecology, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
  • Mubassira Pathan Department of Obstetrics and Gynecology, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
  • Mukul Shah Department of Obstetrics and Gynecology, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India



Fetal Monitoring, Cardiotocograph, Reassuring/non-reassuring pattern


Background: The intrapartum fetal surveillance has gained significant importance. Avoidance of adverse fetal outcome is the objective of intrapartum fetal monitoring. This study helps in forming the aims to provide simple and clear approach to intrapartum fetal surveillance in high risk population.

Methods: In present study 80 laboring patients were analyzed retrospectively who were admitted in GCS Hospital from December 2017 to May 2018. Continuous fetal monitoring was done and results were correlated with maternal and fetal outcome.

Results: Cases with high risk (23) had more non-reassuring pattern of 8.7% as compared to low risk which had 5%. With non-reassuring pattern, C-section was done in 38% whereas in reassuring pattern 85% had vaginal delivery. NICU admission in non-reassuring pattern were 7 (63.6%) whereas in reassuring were only 2 (2.89%). This makes false positivity as 36.4%.

Conclusions: Predictive value of CTG of reassuring pattern is quite high. In spite of false positives, it is a very effective tool in labor room.


Alfirevic Z, Devane D, Gyte GM. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev. 2013;5:CD006066.

Vintzileos AM, Nochimson DJ, Guzman ER, Knuppel RA, Lake M, Schifrin BS. Intermittent electronic fetal heart rate monitoring versus intermittent auscultation: a Meta-Analysis. Obstet Gynecol. 1995;85(1):149-55.

Royal College of Obstetricians and Gynaecologists. The use of electronic fetal monitoring. Evidence-based clinical guideline, number 8. London: RCOG Press; 2001.

Herbst A, Ingemarsson I. Intermittent versus continuous electronic fetal monitoring in labour: a randomized study. Br J Obstet Gynaecol. 1994;101(8):663-8.

Nunes I, Ayres-de-Campos D, Figueiredo C, Bernardes J. An overview of central fetal monitoring systems in labour. J Perinat Med. 2013;41(1):93-9.

Delinger EH, Boehm FH, Crane M M. Electronic Fetal Heart Rate Monitoring: Early neonatal outcome associated with normal rate, fetal stress & fetal distress. Am J Obstet Gynecol. 2000:182:214-98

Sameshima H, Ikenoue T, Ikeda T, Kamitomo M, Ibara S. Unselected low-risk pregnancies and the effect of continuous intrapartum fetal heart rate monitoring on umbilical blood gases and cerebral palsy. Americ J Obstet Gynecol. 2004;190(1):118-23.

Harrington DJ, Redman CW, Moulden M, Greenwood CE. The long-term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort. Am J Obstet Gynecol. 2007;196:463.

Danielian P, Steer PJ. Fetal distress in labour: high risk pregnancy management option. 3rd ed. New Delhi. Elsevi. 2006;1450-72.

Balchin I, Whittaker JC, Lamont RF, Steer PJ. Maternal and fetal characteristics associated with meconium-stained amniotic fluid. Obstet Gynecol. 2011;117(4):828-35.

Hiersch L, Krispin E, Aviram A, Wiznitzer A, Yogev Y, Ashwal E. Effect of meconium-stained amniotic fluid on perinatal complications in low-risk pregnancies at term. Americ J Perinatol. 2016;33(04):378-84.

Rahman H, Renjhen P, Dutta S, Kar S. Admission cardiotocography: Its role in predicting foetal outcome in high-risk obstetric patients. Australas Medic J. 2012;5(10):522-7.

Sandhu GS, Raju R, Bhattacharyya TK. Admission cardiotocography screening of high-risk obstetric patients. Medic J Arm Forc Ind. 2008;64(1):43-5.

Sharbaf FR, Amjadi N, Alavi A, Akbari S, Forghani F. Normal and indeterminate pattern of fetal cardiotocography in admission test and pregnancy outcome. J Obstet Gynaecol Resear. 2014;40(3):694-9.






Original Research Articles