Effectiveness of Admission Cardiotocography on Neonatal Outcomes among High Risk Obstetric Patient (Tripoli Medical Center 2014)

Abstract

Intrapartum fetal surveillance is important to ensure the delivery of a healthy baby with minimum intervention. The
admission cardiotocography (CTG) is a commonly used screening test to identifying pregnant women at high risk of
intraparum fetal hypoxia.
The study was conducted to assess the effectiveness of the admission CTG in detecting fetal hypoxia at time of
admission and to study the relation of the admission CTG results with perinatal outcome in high risk obstetric cases.
The study included 273 high risk pregnant women, meeting the inclusion criteria and admitted to labour ward in
Tripoli Medical Center from January 2014 to August 2014. All women were subjected to an admission CTG, which
included a 20 minute recording fetal heart rate and uterine contraction. Data was analyzed by SPSS program version
16. Both descriptive and inferential statistics was applied and results was interpreted at 0.05 level of
significance.
The study revealed that, the age of the cases was ranged between 17 and 43 years with mean age 28± 4.8 years, more
than half (50.5%) of women were multi para. The commonest risk factor among cases was postdate (44.3%) followed
by premature rupture of membrane (30.4%). Admission CTG was reactive in 78.4% of the cases, suspicious in 13.2%
and pathological among 8.4% of the patients. On comparing admission CTG with the mode of delivery, 8.4% of
the women of the reactive CTG, 25% of suspicious and 91.3% of pathological CTG were had cesarean delivery. In
this study, 39.1% of babies with pathological CTG and (8.3%) of babies with suspicious CTG had Apgar score <7
compared to only (0.9%) of babies in reactive CTG group. There was a significant association between admission
CTG results and low pH of umbilical cord (P = 0.001).
The test can serve as a screening tool for fetuses of high risk obstetric patients and continuous education and training
of obstetrician about CTG to decrease unnecessary interventions is recommended.