Admission cardiotocography: A hospital based validation study.

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Maternal-Fetal Medicine

Background:

• Admission cardiotocography (CTG) is a rapid fetal heart rate (FHR) assessment upon hospital arrival.
• Its utility, particularly in low-risk pregnancies, is debated.
• It aims to expedite interventions for pregnancies with suspected fetal distress.

Purpose of the Study:

• To evaluate the benefit of admission CTG in guiding emergent cesarean delivery decisions.
• To assess if admission CTG was beneficial in cases of suspected fetal distress requiring delivery within one hour of admission.
• To determine the necessity and impact of admission CTG across different risk categories.

Main Methods:

• Retrospective validation study at Karolinska University Hospital (Jan 2011-June 2015).
• Included 40,061 deliveries, identifying 88 cases of emergency cesarean section within one hour of admission for suspected fetal distress.
• Assessed the performance, benefit, and necessity of admission CTG.

Main Results:

• Over 90% (80/88) of included cases showed objective evidence of fetal compromise.
• Admission CTG was beneficial in 74% (54/73) of cases for the decision to perform cesarean delivery.
• Benefit was consistent across low- and high-risk pregnancies; CTG pathology was difficult to identify by auscultation in 28% of cases.

Conclusions:

• Admission CTG is beneficial in a majority of emergent cesarean sections for suspected fetal distress.
• Its value extends to both low- and high-risk pregnancies.
• The findings support the use of admission CTG for timely intervention in fetal distress.