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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.5417.6

Abstract

Background: Labour Admission test (LAT) is a non invasive Cardiotocographic (CTG) recording of foetal heart rate and uterine contractions simultaneously for twenty minutes. This is commonly used to evaluate the foetal well being at the time of admission in labour ward. In a low resource setting where continuous CTG monitoring for all patients in labour is not possible, an abnormal tracing in LAT will help the treating Obstetrician to identify antenatal women who require continuous monitoring and appropriate timely intervention prevent perinatal mortality. Material and Methods: This is a retrospective study done on 300 antenatal women who met the inclusion criteria. The CTG tracing was categorised based on FIGO 2015 guidelines into Normal, Suspicious and pathological. Mode of delivery and specific foetal and neonatal outcome measures were studied and correlated with admission CTG testing. Results: The incidence of operative delivery was phenomenally high in Pathological group (70%) and low in Normal group (5.5%). Foetal distress during labour developed in 8.5% of patients with Normal tracing and 70% of patients with pathological tracing. LAT has a sensitivity of 64.7% and specificity of 94.37% and Positive predictive value (PPV) of 40.4% in predicting an Apgar score of <7 at 5 minutes of birth. NICU admission was required in 1.03% of patients with Normal tracing and 50% of patients with Pathological tracing (Pvalue < 0.001). Conclusion: The result of the study showed high specificity indicating that normal tracing appears to be predictive of foetal well being in low risk and hish risk cases. However, Suspicious and Pathological pattern required intense monitoring and if possible early intervention in the absence of diagnostic modalities like foetal blood gas evaluation.

Keywords: Labour Admission Test (LAT); Cardiotocogram (CTG); Normal; Suspicious; Patholgical. 

Corresponding Author : Kanne Chandrika, Assistant Professor, Department of Obstetrics & Gynaecology, GSL Medical College & General Hospital, Lakshmi Puram, Rajanagarm Rajahmundry, East Godavari (DT), Andhra Pradesh 533296, India.