Cardiotocography was incorporated in clinical obstetrics to reduce intrapartum mortalityand morbidity. Intrapartum monitoring has infact improved fetal outcome and normal survival is now possible in cases considered hopeless years ago.
Cardiotocography is a simple, safe, non-invasive and economical investigation which can be done on every patient in labour. This test should be a part of intrapartum fetal surveillance. The abnormal pattern of are recognized and necessary and timely intervention is done, thereby saving mother and fetus.
Hence this topic has been taken to evaluate the perinatal outcome following the early recognition of abnormal CTG and early intervention made.
. The main goal of the study was to correlate abnormal cardiotocography with Apgar score and perinatal outcome.
. To formulate the plan of action depending on the result and to study the outcome of pregnancy.
. To reduce perinatal mortality and morbidity by including cardiotocography as an routine investigation during vaginal delivery.
Materials and methods: The present study is a Simple Random Sampling which includes minimum of 100 term pregnant women in labour with in a period of 6 months with abnormal cardiotocography admitted in the District headquarters hospital, Apollo institute of medical sciences and research, Chittoor.
All women in active labour with singleton, term pregnancy, with cephalic presentation CTG tracings were taken, preferably 30 minutes before delivery or even earlier with FHR irregularities. CTG tracing were defined as non-reassuring and abnormal patterns as per NICE guidelines 2016.Reassuring patterns were excluded from the study. After delivery Apgar score at 1 and 5 minutes were taken. NICU admission were analyzed and followed up till discharge.
Results: Among the 100 patients 48(48%) showed no reassuring FHR patterns, 52(52%) showed abnormal FHR patterns. variable decelerations were commonest abnormal CTG patterns and seen in 32% of cases, next common was tachycardia in 32%, bradycardia in 30%, late deceleration in 22%, 27% of cases delivered vaginally, among them 19% were in the non-reassuring FHR group.
1 min Apgar score < 7 (depressed) was 29.16% and 40.38%% in non-reassuring and abnormal groups respectively. 5 min Apgar score <7 were 7% and 12% in non-reassuring and abnormal groups respectively. Admission to NICU were 13% and 18% in non-reassuring and abnormal FHR groups respectively and 15 perinatal deaths occurred, 4 in cesarean section group and 4 in instrumental vaginal delivery and 7 in vaginal delivery.
Conclusion: In spite of increased operative delivery there was decreased rate of NICU admissions and neonatal deaths providing that early intervention and resuscitation will improve neonatal outcome. Hereby I conclude that Continuous EFM should be offered and recommended for high-risk pregnancies where there is an increased risk of perinatal death.