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Admission Cardiotocography in Predicting Perinatal Outcome
1Department of Nursing, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
Kathmandu University Medical Journal (KUMJ)
|December 11, 2020
Summary
Admission cardiotocography effectively identifies fetal distress in laboring mothers, predicting outcomes. However, its use in low-resource settings may increase operative deliveries due to limited confirmatory testing.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Maternal-Fetal Medicine
Background:
- Antepartum fetal assessment is crucial for preventing adverse outcomes like intra-uterine demise and neonatal mortality.
- Cardiotocography (CTG) serves as a vital tool for fetal surveillance, particularly in resource-limited settings.
Purpose of the Study:
- To evaluate the utility of on-admission cardiotocography in predicting perinatal outcomes for mothers admitted for delivery.
- To assess the correlation between cardiotocography findings and fetal well-being during labor.
Main Methods:
- A prospective, observational study involving 204 antenatal mothers admitted to Dhulikhel Hospital.
- On-admission cardiotocography was performed for 20 minutes and interpreted using NICE clinical guidelines (2007).
Main Results:
- 81.4% of cardiotocography results were normal, 13.7% suspected, and 4.9% pathological.
- Pathological CTG findings were significantly associated with higher rates of operative delivery (80%) and meconium-stained liquor (p=0.002).
- Fetal distress was observed in 13.3% of normal, 32.1% of suspicious, and 80% of pathological CTG groups (p=0.000).
Conclusions:
- Admission cardiotocography is valuable for detecting existing fetal distress and predicting fetal well-being in the immediate hours of labor.
- The reliance on CTG in low-resource countries might lead to increased operative deliveries due to the absence of fetal blood sampling for hypoxia confirmation.
