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Impact of Intrapartum Cardiotocographic Monitoring On Neonatal Outcome in High Risk Pregnancies: Our Experience

Arul Anne Rose S., Associate Professor, Department of Obstetrics and Gynaecology, Tagore Medical College and Hospital (affiliated to The Tamilnadu Dr. MGR Medical University), Rathinamangalam, Chennai, Tamil Nadu600 127, India. , Arul Anne Rose S.* , Ganitha G.*

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Indian Journal of Obstetrics and Gynecology 5(2):p 7-12, April - June 2017. | DOI: http://dx.doi.org/10.21088/ijog.2321.1636.5217.1

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Abstract

Aim: To evaluate the impact of intrapartum Cardiotocographic (CTG) monitoring on neonataloutcome in high risk pregnancies in our setup. The basic principle of intrapartum fetal monitoring is to identify the developing fetal hypoxia and to intervene appropriately, thereby decreasing the perinatal morbidity and mortality. Methods: It was a hospital based prospective study over a period of one year. Admission CTG was done for the study population, trace was interpreted. The following parameters like color of the liquor, Mode of delivery, Appearance, Pulse, Grimace, Activity and Respiration (APGAR) and Neonatal Intensive Care Unit (NICU) admission were noted and recorded. The results were analysed using SPSS Software version 20. Results: Among the study population 80% had normal trace, 8.7% had suspicious trace and 11.3% had pathological trace. Meconium stained liquor was present in 24.2%, 30.8%, 70.6% of normal, suspicious and pathological traces respectively. 15% of normal trace, 61.5% of suspicious and 88.2% of pathological trace groups were delivered by Lower Segment Caesarean Section (LSCS). APGAR score at 5 minutes of birth was <7 in 3.3%, 38.5% and 82.4% of normal, suspicious and pathological trace groups respectively. When NICU admission was analysed 0.8%, 23.1% and 76.5% of normal, suspicious and pathological trace groups were admitted in NICU respectively. Sensitivity, specificity, positive predictive value and negative predictive value of CTG towards 5min APGAR and NICU admission were calculated based on the results of the normal and pathological trace groups. Conclusion: Our study concluded that the admission CTG can be used as an important non invasive tool to diagnose fetal compromise at the time of admission and during the course of labour in high risk cases especially in the era of potential litigations in Obstetrics.

Keywords: Cardiotocogram; High Risk Pregnancy; Neonatal Outcome. 

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.5217.1

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