TO STUDY THE RELATIONSHIP BETWEEN ANTENATAL CARDIOTOCOGRAPHY AND PERINATAL OUTCOME, MODE OF DELIVERY, MATERNAL COMORBIDITIES.

Sameer Ahmad Lone, Sieqa Shah, Irshad Ahmad Tali, Hilal Ahmad Tali

Abstract


The primary goal of fetal monitoring is a healthy new born with a healthy mother.Cardiotocography as generally accepted, and is most widely used
non-invasive method of monitoring fetal status.There is significant correlation between pathological CTG and the state of the newborn evaluated
by Apgar score, the existence of acidosis, hypoxic-ischemic encephalopathy and subsequent neuromotor development.
AIMS AND OBJECTIVES:To evaluate the relationship between antenatal CTG and perinatal outcome, maternal comorbidities and mode of
delivery.
MATERIAL AND METHODS: This prospective observational study in which 300 women with gestational age of 37-42 weeks with singleton
pregnancy with or without any comorbidity were included after written consent.Women included in the study underwent CTG at the time of
admission and during labour.The cardiotocogram was interpreted as per FIGO guidelines and were allocated the three categories.The need for
neonatal intensive care unit (NICU) admission and maternal comorbidities were correlated with the type of CTG record.
STATISTICAL ANALYSIS : Relationship between antenatal CTG and APGAR score and perinatal outcome were analyzed using Kniskallwallis
test. Two tailed p-values was reported and a p-value <0.05 was taken as statistically significant.
RESULTS : Majority of patients i.e. 197 (65.7%) belonged to the age group of 30-34 years. Patients were divided into three categories. 109
(36.3%) patients fall in category I, 107 (35.6%) in category II, and, 84 (28%) in category III. When correlated with CTG maternal comorbidity was
seen in 39 (35.8%) patients in Category I, 50 (46.7%) patients in Category II and 45 (53.6%) in Category III. Neonatal intensive care unit (NICU)
admission was needed in 67 (22.3%) patients. When CTG was correlated with NICU admission, 4 (3.7%), 15 (14%) and 48 (57.1%) in Category I,
Category II and Category III needed NICU admission.
CONCLUSION: Cardiotocography (CTG) is a simple noninvasive test that can be used to detect fetal distress already present or likely to develop
and prevent unnecessary delay in intervention. Thus it helps in preventing fetal morbidity and mortality. This test is simple, cost effective and can
be utilized in heavy work load hospital/setups with limited resources. With the use of CTG in high risk cases timely intervention can be implied to
reduce the perinatal mortality and morbidity.


Keywords


Cardiotocography, Afgar Score, Fetal Heart Rate, Pregnancy

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