Admission Cardiotocography as a Predictor of Low Apgar Score: An Observational, Cross-Sectional Study

Nazir, Laila; Lakhta, Gul; Anees, Khunsa; Khan, Fahad; Safdar, Sabah; Nazir, G.; Irum, Mehwish I; Khattak, Safi; Salim, Azra

doi:10.7759/cureus.14530

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…Among risk factors for delivery with grade 2 and 3 MSAF, we confirmed a positive correlation with the duration of labor which is expected considering that the physiopathological mechanisms of MSAF can be favored by its prolongation [26]. Similarly, the correlation between abnormal CTG and development of grade 2 and 3 MSAF confirms the results of previous studies [27,28] and can be explained by the fact that both are expressions of fetal distress. In agreement with Kim et al [29] and Salameh et al [30], we confirmed that epidural analgesia increased the risk of grade 2 and 3 MSAF, but this correlation requires further confirmation because other authors have found conflicting results [31,32].…”

Section: Discussionsupporting

confidence: 89%

Neonatal Outcomes of Term Infants Born with Meconium-Stained Amniotic Fluid

et al. 2023

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Background Meconium-stained amniotic fluid (MSAF) is considered an alarming sign of possible fetal compromise and it has recently been reported that neonatal outcome correlates with the degree of meconium thickness. Methods We retrospectively studied 400 term infants allocated in clear amniotic fluid and grade 1, 2, and 3 MSAF groups on the basis of color and thickness of AF. Multivariable logistic regression analysis was performed to evaluate the potential independent effect of delivery with MSAF of different severity on the risk of a composite adverse neonatal outcome. Results We found that delivery with grade 2 (OR 16.82, 95% Cl 2.12–33.52; p = 0.008) and 3 (OR 33.79, 95% Cl 4.24–69.33; p < 0.001) MSAF is independently correlated with the risk of adverse neonatal outcome, such as the occurrence of at least one of the following: need of resuscitation in the delivery room, blood cord pH < 7.100, occurrence of meconium aspiration syndrome (MAS), persistent pulmonary hypertension (PPH), transient tachypnea of the newborn (TTN), acute respiratory distress syndrome (ARDS), hypoxic-ischemic encephalopathy (HIE), and sepsis. Conclusions There is a positive correlation between the severity of amniotic fluid meconium staining and thickness and the outcomes of term infants. Therefore, the evaluation and grading of MSAF during labor is useful in order to plan for the presence of a neonatologist at delivery for immediate and proper neonatal care.

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Section: Discussionsupporting

confidence: 89%

Neonatal Outcomes of Term Infants Born with Meconium-Stained Amniotic Fluid

et al. 2023

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“…Results of our study was comparable to the studies conducted in past. [15,16] Predicting fetal discomfort with cardiotocography in low and high risk pregnancies. Several options exist for dealing with "high risk" women, but there has to be a better way to identify "fetal distress" in "low risk" women [17].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Pregnant Females Presented with Non-Reactive CTG

Memon¹,

Mahar²,

Amanullah³

et al. 2023

PJMHS

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Objective: One of the objectives of this research was to determine the rate outcomes for patients who first presented with non-reactive cardiotocography. Study Design: Descriptive study Place and Duration: Sindh Government Qatar Hospital Orangi town Karachi. Jan 2022-Dec 2022 Methods: 133 women between the ages of 20 and 42 who presented to the OPD or ER with labor pains were included in the research. Abnormalities were seen on both the antepartum and intrapartum CTG. The manner of delivery was decided after a CTG and physical assessment. SPSS 24.0 was used to analyze and input the data. As a follow-up to the stratification process, Chi-square was employed. Values of p less than 0.05 were considered significant. Results: Mean age of the females was 27.14±12.88 years and had mean BMI 36.2±5.81 kg/m2. Mean gestational age of the females was 37.2±3.34 weeks. There were 80 (60.2%) cases had rural residency. Frequency of obesity and anemia was 13 (9.8%) and 18 (13.5%). We found C-section in 58 (43.6%) cases, induction of labor in 42 (31.6%) cases and prolong labor in 33 (24.8%) cases. Frequency of pre-eclampsia found in 46 (34.6%) cases, gestational diabetes in 55 (41.4%) cases and post-partum haemorrhage in 77 (57.9%) cases. Low apgar score found in 25 (18.8%) cases. Conclusion: Cardiotocography monitoring in labor is associated with a higher risk of caesarean sections because of its high false positive rate. Our research shows that pregnant women who are overweight have an increased risk of developing diabetes, premature labor, and preeclampsia and these are contributing factors for non-assuring CTG. Keywords: Non-reactive cardiotocography, C-section, Obesity, Anemia, PPH

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“…Contrary to our study Nazir et al where none of the patients with reassuring CTGs had their neonates admitted to NICU. 17 Only two patients out of 470 had babies with an Apgar score below 6, despite a normal CTG trace. This is because they had taken in all antenatal patients while we had included only high-risk patients.…”

Section: Apgar Score At 5 Minutesmentioning

confidence: 94%

A study on cardiotocography for predicting fetal prognosis in high-risk pregnancy

Kanwat

Singhal

Chauhan

et al. 2023

Int J Reprod Contracept Obstet Gynecol

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Background: The admission cardiotocography (CTG) in high-risk obstetrics patients for continuous monitoring of fetal heart rate (FHR) has become crucial in the modern obstetric practice. It is not only a good screening and inexpensive test but also non-invasive, easily performed and interpreted. Methods: This was a prospective observational study conducted in department of obstetrics and gynaecology, Pannadhay Rajkiya Mahila Chikitsalaya at RNT medical college, Udaipur from April 2022 to September 2022. A total of 100 high risk obstetrics patients were subjected to cardiotocography (CTG). The Women eligible for the study were those who had gestational age ≥32 weeks with cephalic presentation in first stage of labour with singleton fetus in vertex presentation and categorised as high-risk during the time of admission. Results: A total of 100 high risk obstetric patients were subjected to CTG. Out of these common high-risk factors in our study consisted of postdated pregnancy (21%) followed by pre-eclampsia (19%), oligohydramnios (16%) cord around neck (13%). Majority of them (47%) fall under 20-25 years and constituted by primigravida (59%). CTG was reactive in (65%), non-reactive in 25% of cases and 10% patients had suspicious tracings. The incidence of neonatal intensive care unit (NICU) admission, fetal distress and APGAR score less than 7 was significantly higher with suspicious and nonreactive CTG than reactive CTG. Conclusions: CTG test is a simple, non-invasive screening test should be used in high risk pregnancy as admission test. The heavy load of constant monitoring and adverse perinatal outcome can be reduced by CTG monitoring in high-risk obstetrics patients.

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Admission Cardiotocography as a Predictor of Low Apgar Score: An Observational, Cross-Sectional Study

Cited by 5 publications

References 15 publications

Neonatal Outcomes of Term Infants Born with Meconium-Stained Amniotic Fluid

Neonatal Outcomes of Term Infants Born with Meconium-Stained Amniotic Fluid

Outcomes of Pregnant Females Presented with Non-Reactive CTG

A study on cardiotocography for predicting fetal prognosis in high-risk pregnancy

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