Abnormal antepartum cardiotocography and major fetal abnormalities

A 10-year experience of antepartum cardiotocography (8,463 pregnancies) was reviewed to examine the associations with major fetal malformations (278 cases or 3.3%). Patients with critical fetal reserve cardiotocography had a 72% Caesarean section rate (91 of 126) and major fetal malformations were present in 19% (24 of 126) of their infants. Although only 10 of the total 278 malformations (3.6%) were lethal, 6 of these 10 (60%) were associated with a critical reserve antepartum cardiotocographic pattern. As delivery by Caesarean section is usual in patients with critical fetal reserve cardiotocography, it is mandatory to perform ultrasonography to exclude identifiable lethal fetal malformations before delivery.