The importance of antepartum cardiotocography

Breuker, K. H.; Kusche, M; Müller, Ulrike; Bolte, A.

doi:10.1515/jpme.1986.14.3.171

Cited by 3 publications

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“…The tracings were: 86.6% (n-433) had reactive 7.4% (n-37) belonged to suspicious group and 0.6% (n-30) belonged to ominous. 5,6,7 In Kandan Karibu Hospital, Singapore (1998), a study was conducted in 1000 Antenatal women for admission test in high and low-risk pregnancy. 8,9 The tracings were reactive 982 (4.3%), suspicious 49 (4.7%) and ominous 10 (1%).…”

Section: Discussion On Tablementioning

confidence: 99%

Validity of Admission Test as a Screening Test in Differentiating High and Low Observational Antenatal Women- A Prospective Study in a Tertiary Care Hospital

Moorthy¹,

Ramakrishnan²

2017

jemds

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BACKGROUND Non-stress test is a non-invasive test, most commonly used for the antepartum evaluation of foetal well-being. Admission cardiotocogram is usually a 20 mins. recording of foetal heart rate immediately after admission to labour ward. Abnormal tracing might indicate and identify potential foetal compromise at an early stage and allow early intervention. Admission test enable the obstetrician to concentrate more on those foetuses having abnormal tracings than those with reactive tracings. MATERIALS AND METHODS It is a prospective study of assessing the validity of admission test as a screening test to differentiate high and low observational antenatal women. The study was conducted at Institute of Social Obstetrics and Govt. Kasturba Gandhi Hospital, Triplicane, Chennai during the period of April 2007 to April 2008; 800 number of antenatal women who were admitted through casualty were taken for the study based on the inclusion and exclusion criteria. After eliciting the history and complete clinical examination of the patient, the admission test is performed on each patient for 20 minutes. The admission test tracings were typed into-(i) Reactive, (ii) Suspicious, (iii) Ominous. Depending on the type of tracings, the mode of management varies. Patient can be divided into low and high observational status depending upon the tracings. RESULTS In this study, the number of patients in the age group between 18 to 20 years were 80 (10%), 21 to 29 years were 600 patients (75%) and the patients in 30 to 35 years were 120 (15%). In this study, the patients in primi were 496 (62%) and second gravida were 304 patients (38%). Highest number of patients were primi. Among them 784 patients were booked ones and 16 were unbooked. The admission test tracing pattern was such as reassuring pattern in 481 patients, suspicious in 267 patients and ominous in 52 patients. CTG observational status was low in 481 (60.13%) patients and it was high in 319 patients (39.87%). Spontaneous labour occurs in 624 patients (78%) and induced labour in 176 patients (22%). Since "p" value is less than 0.05, there is a significant correlation between type of tracings and mode of delivery. Among the total of 800 patients in this study, 380 (47.5%) number of the patients had the spontaneous labour in the primi gravida and 116 (14.5%) patients had the induced labour. In second gravida, it was about 244 patients (30.5%) in spontaneous labour and 304 (38%) were in induced labour; P value-0.226; statistically no significant relationship exists between Gravida and type of Labour. In this study, APGAR score more than 7 patients were 561 number (70.1%) and foetal outcome was good in 561 patients and it is poor in 239 patients. In this study the highest number of patients, 361 had the babies with birth weight of 2.4 to 2.7 Kgs. CONCLUSION The study shows that there is a good correlation between reactive tracings and good foetal outcome even with less frequent monitoring. Hence, the admission test can be used as a useful tool to differentiate between thes...

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Section: Discussion On Tablementioning

confidence: 99%

Validity of Admission Test as a Screening Test in Differentiating High and Low Observational Antenatal Women- A Prospective Study in a Tertiary Care Hospital

Moorthy¹,

Ramakrishnan²

2017

jemds

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“…Lubna et al done an observational study in low-risk women showed frequency of 6.35% of pathological cardiotocography in labour [14]. Khursheed et al reported prevalence to be 11% [15] and in contrast Breuker and associate reported prevalence of pathological CTG in low-risk pregnancies as 3.1% only [16]. Out of pathological CTGs, only 18.18% of newborns had Apgar score below seven at five minutes.…”

Section: Literature Reviewmentioning

confidence: 99%

Admission Cardiotocography: Its Role in Predicting Perinatal Outcome in Term, Uncomplicated (Low Risk) Pregnant Women in Spontaneous Labour

Tharindu¹

2023

OJOG

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Introduction: Labour admission cardiotocography (CTG) is commonly used non-invasive method of fetal monitoring in Sri Lanka. It may have a potentialto predict perinatal outcome in low-risk term pregnancies. Objectives: Objectives of the study were to determine the perinatal outcomes of normal, suspicious and pathological admission CTGs and role of labour admission cardiotocography as a predictive test for perinatal outcome in low-risk term pregnancies in spontaneous labour. Methods: This study was a prospective observational study done involving 445 low risk, term pregnancies in spontaneous labour. Labour admission CTG was performed in each pregnancy and categorized into normal, suspicious and pathological CTG according to criteria depicted by National Institute of Clinical Excellence (NICE) guideline 2007. Apgar score less than 7 at five minutes, resuscitation at birth, admission to neonatal intensive care unit (NICU), seizure within first 24 hours of birth and meconium-stained amniotic fluid were the primary outcome measures to assess fetal asphyxia. Mode of delivery in each category, nuchal cord at birth were also assessed. Results: Majority of participants were in 25-to-29-year age group and were nulliparous. Frequencies of normal, suspicious and pathological CTG were 74.8%, 18% and 7.2% respectively. Pathological CTG was significantly associated with low Apgar score compared to non-pathological CTG group (p < 0.005) while other outcome measures were not significant. Rate of operative delivery was 68% in pathological group and 20.8% in nonpathological CTG group. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of labour admission CTG to detect fetal asphyxia were 51.85%, 95.69%, 43.75% and 96.85% respectively. Conclusions: Incidence of pathological labour admission CTG was 7.2%. Apgar How to cite this paper: Tharindu, E.A.D.

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Comparison of umbilical arterial versus umbilical venous blood PH correlated with arterio-venous glucose difference and cardiotocographic score

et al. 1993

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The value of clinical parameters and umbilical arterial blood pH as indicator of prenatal hypoxia is disputed. In a prospective study of 86 vaginally delivered full-term infants, cardiotocographic (CTG) findings obtained 0-30 min and 30-60 min before birth were compared to pH values, O2 and CO2 partial pressures and glucose difference in umbilical arterial and venous blood. CTG findings were expressed as a score, higher values indicating fetal hypoxia. The venous but not the arterial blood pH was significantly related to the later (0-30 min) CTG score. The arterio-venous glucose difference was significantly related to both CTG scores. There was a significant statistical relationship between glucose difference and venous but not arterial blood pH. The later CTG score (0-30 min) also correlated significantly with O2 and CO2 partial pressures and base excess in the umbilical vein of all vaginally born infants. If CTG is accepted as an objective indicator of fetal hypoxia before birth, the arterio-venous glucose difference, and in the investigated range of pH-values, umbilical venous blood pH are more suitable than the arterial blood pH to ascertain the peripartal situation of the newborn.

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The importance of antepartum cardiotocography

Cited by 3 publications

References 4 publications

Validity of Admission Test as a Screening Test in Differentiating High and Low Observational Antenatal Women- A Prospective Study in a Tertiary Care Hospital

Validity of Admission Test as a Screening Test in Differentiating High and Low Observational Antenatal Women- A Prospective Study in a Tertiary Care Hospital

Admission Cardiotocography: Its Role in Predicting Perinatal Outcome in Term, Uncomplicated (Low Risk) Pregnant Women in Spontaneous Labour

Comparison of umbilical arterial versus umbilical venous blood PH correlated with arterio-venous glucose difference and cardiotocographic score

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