Role of Cardiotocography in predicting perinatal outcome in high-risk pregnancy

Abstract

DOI: 10.4328/ACAM.20281 Received: 2020-07-14 Accepted: 2020-08-11 Published Online: 2020-08-28 Printed: 2021-03-01 Ann Clin Anal Med 2021;12(3):313-316 Corresponding Author: Sangam Jha, Department of obstetrics and gynecology, AIIMS Patna, Phulwarisharif, Bihar, India. E-mail: [email protected] P: 91-9827388001 Corresponding Author ORCID ID: https://orcid.org/0000-0002-4349-1589 Abstract Aim: In this study, it was aimed to evaluate the efficacy of fetal cardiotocography in predicting perinatal outcome. Materials and method: In this retrospective observational study, 400 gravid women with high-risk pregnancy fulfilling the eligibility criteria were enrolled. The results of CTG were studied according to NICE 2017 guidelines. Perinatal outcomes were studied by the color of liquor, Apgar score at one minute and five minutes, and NICU admission. Statistical analysis was done using a t-test and pvalue <0.05 was considered statistically significant. Results: PIH was the most common risk factor in 32 % of females. CTG was reactive in 163(40.7%) patients and nonreactive (suspicious and pathological) in 237(59.2%) patients. One hundred thirty (54%) females with nonreactive CTG had meconium-stained liquor compared to only 18(11%) in the reactive group (pvalue<0.05). In the reactive group, only 4% of babies had Apgar 5min <7 compared to 32.4% in the non-reactive group. Perinatal morbidity in the form of NICU admission was higher in the non-reactive group in 77 (32.4%) patients compared to 7 (4%) patients in the reactive group. The sensitivity and specificity of CTG for predicting neonatal morbidity were 63% and 80.4%, while it’s PPV and NPV were 49.4% and 89.4%, respectively. Discussion: CTG has shown high specificity and negative predictive value for detecting adverse perinatal outcomes in this study. This appears to be a simple, non-invasive test that can serve as a screening tool to detect fetal distress that is already present or likely to develop during labor in high-risk obstetric patients in centers with a heavy workload.