Vishnu Bhartiya1, Richa Sharma1, Anand Kumar2, Himsweta Srivastava1. 1. Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi 110095 India. 2. Mrs. Girdhar Lal Maternity Hospital, Jawaharlal Nehru Marg, New Delhi, Delhi 110002 India.
Abstract
BACKGROUND: Screening for fetal distress is a big challenge for obstetricians. Labor admission test by cardiotocography (CTG) can be utilized to differentiate between mothers, in whom continuous fetal monitoring is needed and those who can be managed by intermittent auscultation. Admission CTG is commonly used screening test which aims to identify on admission to the delivery unit the fetus at increased risk of intrapartum hypoxia. We conducted a study to evaluate the efficacy of CTG in low- and high-risk women. METHODS: A prospective longitudinal study was conducted on 200 low-risk and high-risk antenatal women, beyond 32-week gestation with live pregnancy in labor and admitted in labor ward. RESULTS: Correlation of labor admission test with meconium in low risk and high risk was found statistically significant (p = 0.0010 and p = 0.000046, respectively). Correlation of labor admission test with low Apgar score, NICU admission and mortality was found statistically insignificant in low-risk and high-risk groups. CONCLUSION: Admission CTG does not benefit the neonatal outcome in normal- or low-risk women and rather results in increased obstetric intervention. Thus, it is not beneficial as a screening test to detect intrapartum fetal distress in normal- or low-risk women.
BACKGROUND: Screening for fetal distress is a big challenge for obstetricians. Labor admission test by cardiotocography (CTG) can be utilized to differentiate between mothers, in whom continuous fetal monitoring is needed and those who can be managed by intermittent auscultation. Admission CTG is commonly used screening test which aims to identify on admission to the delivery unit the fetus at increased risk of intrapartum hypoxia. We conducted a study to evaluate the efficacy of CTG in low- and high-risk women. METHODS: A prospective longitudinal study was conducted on 200 low-risk and high-risk antenatal women, beyond 32-week gestation with live pregnancy in labor and admitted in labor ward. RESULTS: Correlation of labor admission test with meconium in low risk and high risk was found statistically significant (p = 0.0010 and p = 0.000046, respectively). Correlation of labor admission test with low Apgar score, NICU admission and mortality was found statistically insignificant in low-risk and high-risk groups. CONCLUSION: Admission CTG does not benefit the neonatal outcome in normal- or low-risk women and rather results in increased obstetric intervention. Thus, it is not beneficial as a screening test to detect intrapartum fetal distress in normal- or low-risk women.
Entities:
Keywords:
Admission cardiotocography; Perinatal outcome; Screening test
Authors: Lawrence Impey; Margaret Reynolds; Kathryn MacQuillan; Simon Gates; John Murphy; Orla Sheil Journal: Lancet Date: 2003-02-08 Impact factor: 79.321