European Journal of Molecular & Clinical Medicine

Abstract

Aim: To assess the reliability of continuous fetal heart rate monitoring in detecting
fetal distress in pregnant women in labor.
Materials and methods: In our prospective study, term patients who were admitted in latent or active phase of labor in CKM hospital, were subjected to intra-partum fetal heart monitoring with cardio-toco-graph.
Results:  Average age group of our study population was 23 years, average gestational age- 39 weeks and average neonatal birth weight was 3.04 kgs. 6% normal, absent variability in 33%, minimal variability in 40%, moderate variability in 17%, and sinusoidal pattern was observed in 4%. All the abnormal CTGs were divided according to NICHD into 3 categories and 6% had category I CTG, 58% had category II CTG and 36% had category III abnormal CTG of 100 women. Out of 36 women categorized under NICHD III, 27(75%) had intra-op abnormalities and the association was significant, while out of 58 women with NICHD category II CTG abnormality, 17(29%) had abnormal intra-op findings and none of the women with category I abnormal CTG tracings had significant findings. 17(47%) neonates of 36 who had category III abnormal tracing intra-partum, had APGAR </= 7 which was statistically significant and 5(8%) neonates of 58 with category II tracing, had APGAR </= 7. 29 of 36(80%) neonates who had category III tracing intra-op required NICU admission which was statistically significant and 11 of 47(24%) neonates with category II required admission.
Conclusion: Electronic fetal monitoring is a useful intrapartum tool, if used judiciously and according to evidence-based guidelines and can be used to improve perinatal outcomes.