Role of Abnormal Intrapartum CTG in Predicting Adverse Fetal Outcome

Abstract

Introduction: Abnormal CTG is more commonly associated with fetal distress, meconium stained liquor and NICU admission. Incidence of abnormal fetal heart rate pattern were 2.3 times as common in babies who developed cerebral palsy and 6.7 times as common in perinatal death. Moreover, there is inter-observer variation in interpretation of abnormal cardiotocography readings and recommendations for interventions.

Objectives: To assess the frequency of adverse fetal outcome (in terms of Apgar score <7 at 1 minute) in females with abnormal CTG.

Study design: Descriptive, case series.

Settings: Department of Obstetrics & Gynecology, KRL Hospital, Islamabad.

Study duration: 30th September 2018 to 29th March 2019.

Materials & Methods: A total of 96 pregnant females with abnormal intrapartum CTG and 18 to 40 years of age were included. Patients with obstetric emergencies e.g. severe APH, Cord prolapse, hand prolapse and intrauterine fetal death were excluded. CTG was conducted by the trained staff in labor room of all selected patients in active phase of labor. All cases were followed till delivery and adverse fetal outcome in terms of Apgar score <7 (yes/no) was noted.

Results: Age range in this study was from 18 to 40 years with mean age of 28.05 ± 5.06 years. Majority of the patients i.e. 74 (77.08%) were between 18 to 30 years of age. Mean gestational age was 38.82 ± 0.92 weeks. Mean parity was 1.45 ± 1.90. Mean BMI was 30.51 ± 2.33 kg/m2. Adverse fetal outcome (in terms of Apgar score <7 at 1 minute) in females with abnormal CTG was found in 37 (37.50%) while 60 (62.50%) patients showed no adverse fetal outcome.

Conclusion: This study concluded that frequency of adverse fetal outcome (in terms of Apgar score <7 at 1 minute) in females with abnormal CTG is quite low.