The Role of Cardiotocography in Monitoring Fetal Condition During Labour in High Risk Pregnancy and Its Correlation with Perinatal Outcome

Muhabad Ameen   Ameen; Amal Abdulhakim  Ahmed; Maida Yousif  Shamdeen

doi:10.56056/amj.2022.161

Authors

Muhabad Ameen Ameen M.B.Ch.B, KBMS Student Obstetrics and gynecology, Duhok Teaching Hospital of Obstetrics and gynecology
Amal Abdulhakim Ahmed M.B.Ch.B, F.I.B.M.S.O.G, lecturer, Obstetrics and gynecology Department, College of Medicine, University of Duhok.
Maida Yousif Shamdeen Prof. MRCOG /FRCOG. Gynecology and Obstetrics Department, College of Medicine, University of Duhok, Duhok, Iraqi Kurdistan

DOI:

https://doi.org/10.56056/amj.2022.161

Keywords:

High-risk pregnancy, Cardiotocography, Complications

Abstract

Background: Cardiotocography (CTG) is considered to be a non-invasive prenatal screening technique. It is used to monitor fetal condition during labor.

Objectives: this study aimed to evaluate the role of Cardiotocography as a screening tool during labor in high risk pregnancy for determining perinatal outcomes.

Methods: In this cross-sectional study, Cardiotocography was performed randomly on 200 pregnant women with risk factors (postdate, oligohydronomia, Pregnancy-induced hypertension, diabetes mellitus, anemia, intrauterine growth retardation, Antepartum hemorrhage, and pre-labor rupture of membrane who attended the labor ward of Duhok Teaching Hospital of Obstetrics and Gynecology from 20 October 2019 to 15 February 2020 and the results of CTG were categorized a reactive and non-reactive cardiotocography tracing groups and the perinatal outcomes were correlated with cardiotocography results.

Results: In this study, the mean age of patients was 27.41±6.09 years; ranged 18-42 years. There was no significant difference in the mean age of the patients (27.48±6.17 vs. 27.33±6.05 years), gravida (2.49±1.73 vs. 2.10±1.53) and gestational age (39.85±1.40 vs. 39.84±1.41weeks) between patients with reactive and non-reactive cardiotocography tracing, respectively. Patients with reactive cardiotocography were significantly more likely to have live babies (1.52±1.77 vs. 0.54±0.67) and no dead babies was recorded between reactive and non-reactive cardiotocography groups. The rate of caesarean section was significantly higher in patients with non-reactive cardiotocography (64.4% vs. 38.4%) and for bloody liquor (7.9% vs. 2.0%). It was also observed that low Apgar score 0-4 in first minute (12.9% vs. 4.0%) and 5-7 Apgar score in five minutes (34.7% vs. 9.1%) and admission to neonatal intensive care unit were significantly higher in patients with non-reactive than in those with reactive cardiotocography (59.4% vs. 26.3%), respectively.

Conclusions: This study showed that cardiotocography is a useful technique to determine perinatal outcomes in high-risk pregnancies.

Downloads

Download data is not yet available.

References

-Haws R, Yakoob M, Soomro T, et al. Reducing stillbirths: screening and monitoring during pregnancy and labour. BMC pregnancy childbirth. 2009;9(1): S5.

-Burrow GN, Duffy TP. Medical complications during pregnancy. Philadelphia, Pa. WB Saunders; 1999.

-Sandhu G, Raju R, Bhattacharyya T. Admission cardiotocography screening of high risk obstetric patients. Med J Armed Forces India. 2008;64(1):43-5.

-Arulkumaran SS, Arjun G, Penna LK. The management of Labour: universities press; 2011.3rd ed. Hyderabad, India: Universities Press; 2011. p. 453.

-Van Leeuwen P, Geue D, Lange S, et al. Changes in the frequency power spectrum of fetal heart rate in the course of pregnancy. Prenat Diagn. 2003;23(11):909-16.

-Gupta M, Nagar T, Gupta P. Role of cardiotocography to improve perinatal outcome in high risk pregnancy. IJCMR. 2017;4(4):853-6.

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

-Parer J, Livingston E. What is fetal distress? Am J Obstet Gynecol. 1990;162(6):1421-7.

-Turner JM, Mitchell MD, Kumar SS. The physiology of intrapartum fetal compromise at term. Am J Obstet Gynecol. 2020;222(1):17-26.

-Santo S, Ayres?de?Campos D, Costa?Santos C, et al. Agreement and accuracy using the FIGO, ACOG and NICE cardiotocography interpretation guidelines. Obgyn. 2017;96 (2):166-75.

-Faruqi M, Shrestha SC, Bhatta RD. Pregnancy outcomes of normal versus abnormal cardiotocography in a tertiary centre in Nepal. Int J ReprodContraceptObstet Gynecol. 2019;8(11):4407.

-Khatun A, Khanam NN, Nazir F. Role of Elaborate Cardiotocography (CTG) in Pregnancy Management. BSMMU J. 2009;2(1):18-24.

-Sood AK. Evaluation of Non Stress test in high risk pregnancy. J Obstet Gynecol India. 2002;52(2):71-5.

-Behuria S, Nayak R. Admission cardiotocography as a screening test in high risk pregnancies and its co-relation with peri-natal outcome.Int J Reprod Contracept Obstet Gynecol 2016;5(10):3525-8.

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