CARDIOTOCOGRAPHY

ROLE OF INTRAPARTUM CARDIOTOCOGRAPHY IN EVALUATING FETOMATERNAL OUTCOME

Abstract

Introduction: The cardiotocography (CTG) is more commonly knows as
electronic fetal monitoring (EFM). A cardiotocography measures the fetal heart and the frequency
of uterine contractions. Using two separate disc shaped transducers. Objectives: The objective
of this study is to co-relate the intrapartum cardiotocography monitoring with fetomaternal
outcome. Study Design: Cross sectional analytical study. Setting: Department of Obstetrics
and Gynaecology, Shaikh Zayed Hospital, Lahore, Pakistan. Period: From September 2012 to
March 2013 (Six Months). Patient & Method: Total 60 patients (pregnant females) fulfilling the
inclusion criteria were selected for this study, who were admitted in labour room in early and
active labour. In group A normal CTG monitoring and in Group B women with abnormal CTG
monitoring. Maternal outcomes in terms of mode of delivery and fetal outcome (APGAR Score,
neonatal seizures, admission to nursery and time of neonatal discharge were seen). Result: The
mean age in group A was 26.13+3.90 years and in group B was 26.53+4.17 years. The mean
gestational age in group A was 38.40+1.50 weeks and in group B was 36.60+1.59 weeks. In
group A, 25 (83.3%) woman were delivered through spontaneous vaginal birth and 4(13.4%)
women, who were delivered by caesarean section (for all indication except fetal distress), 1
(3.3%) woman by assisted vaginal birth (for all other indications). In group B there were 7(23.8%)
women who delivered through spontaneous vaginal birth. 3(10%) women by assisted vaginal
birth (for abnormal CTG monitoring) and 20(66.7%) women by caesarean section (for abnormal
CTG). In group A, there were 7(23.3%) neonates who were admitted in nursery, while in group
B, there were 19(63.3%) neonates, who were admitted in nursery. Conclusion: Intrapartum
external fetal cardiotocography is not a single indicator of fetal distress. An increased caesarean
section rate in babies with a pathological cardiotocography stresses on the need for additional
tests to differentiate hypoxic fetuses from non-hypoxic.