Labour admission test--an effective risk screening tool

Recording of foetal heart tracing on cardiotocogram for 30 minutes was done in 500 women on admission in labour and contraction mediated responses were recorded as labour admission test (LAT). Subjects were also stratified into high or low risk groups based on antenatal factors. Seventy-seven out of 500 labour cases (36 out of 433 cases with reactive, 16 out of 37 with suspicious and 25 out of 30 cases with ominous LATs) manifested foetal distress. Eighty-two per cent of antenatal high risk and 89% of low risk pregnancies showed reactive LATs. The LAT was found to have high specificity (93%) and negative predictive value (91%). However, the sensitivity and positive predictive values were lower (53% and 61% respectively). Patients with pre-existing risk factors showed intrapartum foetal distress by 3 hours of reactive LAT, whereas the ones with no antenatal risk factors did not develop foetal distress till 6 hours after reactive LAT. Reactive LAT tracing is of some predictive value; at least for the first few hours after admission in labour.