ROLE OF CARDIOTOCOGRAPHY IN EARLY DETECTION OF ABNORMAL FETAL HEART RATE PATTERNS AND THEIR EFFECT ON PERINATAL OUTCOME.

Abstract

Background : Delivery of healthy baby to healthy mother is the aim of the management of every pregnancy which is only
possible if proper heart rate monitoring is done. All know that the uterine contractions may be a source of stress along
with other indicators like meconium stained liquor(MSL),placental infarction, cord compression and oligohydramnios.
Objective: To detect fetal distress through CTG early so that timely management can be done and to find out perinatal
outcome in cases of non reassuring Cardiotocography(CTG) tracings and correlating it with intraoperative findings for
cause of fetal distress.
Methods: It is a case control interventional study conducted in Mahatma Gandhi Medical College and Hospital in
department of Obstetrics and Gynaecology from January 2018 to June 2019 time period in which 180 patients with
abnormal CTG findings were studied which were compared with control group of other 180 patients having absolutely
normal CTG for perinatal outcome and Neonatal intensive critical unit (NICU) admission , intraoperative findings were
correlated . For all patients CTG tracings were correlated with intraoperative findings and perinatal outcome were
analyzed and statistical evaluation done.
Results: Among 180 subjects of case group,4 cases had bradycardia and late deceleration only, 83 cases had
bradycardia , late deceleration & decreased variability , 9 cases had bradycardia only,38 cases had bradycardia with
decreased or absent variability and 46 cases had Tachycardia with decreased or absent variability. There was a positive
correlation between non reassuring and abnormal CTG with intraoperative findings with MSL was 46.6% with P value
<0.001, oligohydramnios was 32.2% with P value <0.001 , Cord around neck was 41.1% with P value <0.001, NICU
admission were only 13.3 % and was less significant . Perinatal outcome was good because timely decision was taken
based on CTG tracings.
Conclusion: CTG patterns are highly predictive of fetal hypoxia, they correlate well with causes of fetal distress, low
Apgar score and NICU admissions therefore every labour should be monitored by CTG for the best perinatal outcome
.However proper interpretation of fetal heart tracing is necessary so that rate of unnecessary cesarean doesn't rise
simultaneously , the cases of fetal distress are not missed to improve the fetal outcome.