ABNORMAL CARDIOTOCOGRAPHY FINDINGS AND ITS ASSOCIATION WITH ADVERSE FETAL OUTCOMES

Sumona Yesmin*, Fahmida Sultana Mili and Nilufar Sultana

ABSTRACT

Prediction of the perinatal outcomes is important for high-risk pregnant patients presenting with different medical and obstetrical complications by Cardiotocography (CTG). Objectives: The study was carried out to evaluate whether abnormal cardiotocography can reflect fetal hypoxia and predict fetal outcomes and to what extent one can rely on CTG record. Material & Method: Prospective observational study was done on 101 high risk pregnant patients presented in Department of Obstetrics and Gynae, Dhaka Medical College Hospital, meeting the inclusion criteria were subjected to perform CTG testing. The CTG tracing was categorized according to the National Institute for Health and Care Excellence (NICE) guideline into normal, suspicious and pathological CTG tracing groups. Both suspicious and pathological CTG were considered here as abnormal CTG tracing group. Specific fetal outcome measures were observed and correlated with CTG tracing. Result: Fetal distress developed during delivery in 3.39% of patients with a normal CTG tracing whereas 54.76% patients with an abnormal CTG tracing. The admission test had sensitivity 92%, specificity 75%, positive predictive value 54.8% and negative predictive value 96.6% for predicting Apgar score <7 in one minute. Admission in neonatal intensive care unit was required in 1.69% of patients with normal CTG trace and 35.7% patients with abnormal CTG trace. Conclusion: Significant relationship with high sensitivity and high negative predictive value was found between CTG tracing and fetal outcomes.

Keywords: Cardiotocography, CTG tracing, Abnormal Fetal Outcomes, Apgar Score.