International Journal of Clinical Obstetrics and Gynaecology

Background: Cardiotocography (CTG) is worldwide the method for fetal surveillance during labor. 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 labor. Two clinical trails have shown that a combination of CTG and ST –analysis of the fetal electrocardiogram (ECG) reduces the rates of metabolic acidosis and instrumental delivery.

Objectives: To observe the antepartum cardiotocography and fetal outcome in high risk pregnancy.

Place of study: Department of Obstetrics and Gynaecology, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh.

Period of study: October 2019 to March 2020.

Study design: Prospective cross sectional study.

Methods: It was a prospective cross sectional study carried out in the department of Obstetrics and Gynaecology, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh. Thereafter, they were scrutinized according to eligibility criteria and 60 patients were finalized. Sixty 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.

Results: This study shows highest percentage 20 (33.3%) of age group 21-25 years. The mean ±SD was 23.25±4.18. CTG shows 44(73.3%) had normal CTG and 16(26.7%) had abnormal CTG. Regarding birth weight 22 (36.7%) were <2.5 kg and 38(63.3%) were >2.5 kg. 15(25%) had apgar score <7 and 45 (75%) had Apgar score >7. There was significantly higher caesarean delivery, lower Apgar score, higher admission at neonatal unit among the abnormal CTG group.

Conclusion: This study shows 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.