Antenatal cardiotocography for fetal assessment

Area of Science:

• Obstetrics and Gynecology
• Fetal Monitoring
• Evidence-Based Medicine

Background:

• Cardiotocography (CTG) is a standard method for assessing fetal well-being during pregnancy, particularly in high-risk cases.
• It involves continuous recording of fetal heart rate using an abdominal ultrasound transducer.
• Its effectiveness in improving maternal and infant outcomes remains a subject of investigation.

Purpose of the Study:

• To evaluate the effectiveness of antenatal cardiotocography (CTG), both traditional and computerised, in enhancing maternal and infant outcomes.
• To synthesize evidence from randomized and quasi-randomized trials comparing different antenatal CTG approaches.

Main Methods:

• Searched the Cochrane Pregnancy and Childbirth Group's Trials Register and reference lists.
• Included randomized and quasi-randomized trials comparing traditional CTG, computerised CTG, and no CTG.
• Two independent reviewers assessed eligibility, quality, and extracted data.

Main Results:

• Six studies involving 2105 women were included; overall study quality was low.
• Traditional antenatal CTG showed no significant difference in perinatal mortality or caesarean sections compared to no CTG.
• Computerised CTG significantly reduced perinatal mortality compared to traditional CTG, but evidence for other outcomes was limited.

Conclusions:

• Current evidence does not definitively support antenatal CTG's effectiveness in improving perinatal outcomes.
• Further research is recommended, particularly on computerised CTG in high-risk pregnancy populations.
• The limited quality and power of existing studies necessitate cautious interpretation.