Habiba Akther1, Jakia Jahan Chowdhury2, Mirza Osman Beg3, Nahid Elora4
1. Assistant Professor, Department of Gynae and Obstetrics, North East Medical College, Sylhet
2. Resident Surgeon, Department of Gynae and Obstetrics, North East Medical College, Sylhet
3. Assistant Professor, Department of Orthopaedics, North East Medical College, Sylhet
4. Professor, Department of Gynae and Obstetrics, North East Medical College, Sylhet
Abstract
Cardiotocography (CTG) is worldwide method to see the fetal surveillance during pregnancy and labour. However, CTG alone shows many false positive test results and without fetal blood sampling (FBS), it results in an increase in operative deliveries without improvement of fetal outcome FBS requires additional expertise, is invasive and has often to be repeated during labour. Two clinical trials have shown that a combination of CTG and ST-analysis of the fetal electrocardiogram (ECG) reduces the rates of metabolic acidosis and instrumental delivery. This prospective cross sectional study was carried out in the Department of obstetrics, Ad-din Women’s Medical College & Hospital, Dhaka to see the fetal outcome in high risk pregnancy by antepartum cardiotocography 100 consecutive CTG tracings were collected from patients who were advised to perform CTG after admission. Statistical analysis was carried out by chi-square test. Level of significance was set at P value < 0.05. This study showed highest proportions (40%) of women were in the age group of 26-30 years. The mean±SD was 26.40±4.61 years. 75(75%) had normal CTG and 25(25%) had abnormal CTG. Regarding birth weight 39(39) were <2.5 kg and 61(61%) were 2.5 kg. 25% had Apgar score <7 and 75(55%) had Apgar score >7 There was significantly higher caesarean delivery, lower Apgar score, higher admission at neonatal unit among the abnormal CTG group. This study showed that lower Apgar score and low birth weight were associated with abnormal CTG. CTG can be continued as a good screening test of fetal surveillance but it is not the sole criteria to influence the management of high-risk pregnancies. Abnormal CTG should be supplemented with other test before intervention.
Key Words: Antepartum, Cardiotocography, High risk pregnancy