A Comparative Study Between Intermittent Auscultation and Cardiotocogram in Low Risk Pregnancy During Labour

Abstract

The goal of foetal heart rate (FHR) monitoring has been early identification of the foetus at risk for hypoxic insult. The aim
of this study is to establish the relation between FHR monitoring (cardiotocogram (CTG) and intermittent auscultation)
and foetal outcome and mode of delivery. It is a prospective observational comparative study carried out on the maternity
ward of the Zawia hospital.
Study population consists of 200 women in labour having the criteria of low risk group including singleton pregnancies
between 37-40 weeks gestation, in 100 of them foetal monitoring was done by continuous electronic monitoring by CTG,
the other 100 was monitored using intermittent auscultation by Pinard stethoscope (foetoscope). Caesarean sections were
performed for both groups (31% of electronic monitoring group and 6% of Pinard stethoscope monitoring group) (P =
0.000 which is statistically significant).
Three cases were delivered by instrumental delivery (ventose), one in CTG and 2 in (foetoscope) group. Abnormalities
in foetal heart rate were detected in 12% of electronic monitoring group and in 3.5% of the Pinard stethoscope group.
The Apgar score of babies in both groups nearly the same (P = 0.411). The number of babies transferred to intensive care
unit is higher in CTG group (26%) than the other group (20%) P = 0.374. One baby in CTG group had neonatal seizure.
We conclude that, abnormalities in foetal heart rate were more reliably detected by electronic monitoring than with Pinard
foetoscope. However, use of continuous electronic monitoring carry higher rate of caesarean section with no significant
difference in neonatal outcome