A prospective study on the evaluation of intrapartum cardiotocogram and cord blood pH as indicators of perinatal outcome

Abstract

It is a prospective observational study conducted over a period of 2 years in newlineChettinad Health and Research Institute. 100 pregnant women who had intrapartum newlinefetal distress were included in the study. Fetal heart rate during labour was monitored newlinewith intermittent auscultation and CTG tracings were taken in active stage at an newlineinterval of 2-4 hrs. Occurence of meconium stained amniotic fluid was noted. After newlinedelivery APGAR score was noted and umbilical cord blood was collected. newlineRESULTS newlineOut of 100 CTG tracings, 42 were pathological and 58 were suspicious. newlineAmong the patients with pathological trace 2(4.76%) had clear liqour, 8(19.04%) had newlinegrade I MSL, 19(45.2%) had grade II MSL, 13(30.9%) had grade III MSL. In the newlinesuspicious trace group, 29(50%) had clear liqour, 13(22.4%) had Grade I MSL, newline8(13.7%) had grade II MSL, 8(13.7%) had grade III MSL. Among the patients with newlinepathological CTG, 20(47.6%) had cesarean section, 14(33.3%) has normal vaginal newlinedelivery and 1% had assisted vaginal delivery. Among the patients with pathological newlinetrace, 32(84.2%) had a cord blood pH lt7.2 and 10(16.1%) had pH gt7.2. In the newlinesuspicious trace group, 6(15.8%) had cord pH lt7.2 and 52(83.9%) had pH gt7.2. newlineAmong the patients with pathological trace at 1 min, the APGAR score was lt3 in newline4(9.52%), 4-6 in 25(59.5%), 7-10 in 13(30.9%). At 5 min 12(28.5%) had APGAR newlinebetween 4-6, 30(71.4%) was inbetween 7-10. In the suspicious group at 1 min, newline14(24.13%) had an APGAR of 4-6 and 44(75.8%) had a score of 7-10. At 5 min, newline6(10.3%) had an APGAR score of 4-6 and 52(89.6%) had score of 7-10. There were a newlinetotal of 62 NICU admissions of which 28 had suspicious CTG and 34 had newlinepathological CTG. newlineCardiotocography is a non invasive method of intrapartum fetal monitoring. It newlinehas a high sensitivity but its specificity is low. No doubt with the introduction of CTG newlineinto clinical practice, there has been an increase in the rate of cesarean sections and newlineoperative vaginal deliveries. For suspicious traces, the association with fetal acidosis newlineis low.