A Study of Cardiotocography During Active Labour to Assess the Perinatal Outcome in High Risk Pregnancy

Introduction: Cardiotocography is a test performed duringactive labour. It was used to assess the fetal wellbeing. Aim: To evaluate the CTG in high risk pregnancies and assess the perinatal outcome. Materials and Methods: Prospective observational study was conducted on 105 high risk pregnant patients fulfilling the eligibility criteria & written informed consent. Complete clinical & obstetrics examination was done. CTG monitoring was done during active labour. The results of CTG were studied according to NICE guidelines. Perinatal outcome were studied by Apgar score, NICU admission. Results: Out of 105 patients 56.2% were primigravida. Post datism was the most common risk factor present in 35.2% females followed by PIH (31.4%), oligohydramnios (18.1%), Anaemia (17.1%), Prev. LSCS (16.2%) and IUGR (16.2%). Normal CTG pattern was observed in 62.9% while suspicious and abnormal pattern was observed in 13.3% and 23.8% pregnancies respectively. Over one third of females with suspicious and abnormal CTG pattern had Thick Meconium Stained Liquor (MSL) during pregnancy. (p< 0.05) The association of abnormal pattern in CTG and caesarean section was found to be statistically significant (p<0.001). The Sensitivity and Specificity of CTG for predicting neonatal morbidity was 81.25% and 82.2%, while it's PPV and NPV was 66.6% and 90.9%. Conclusion: CTG appears to be a simple non-invasive test that can serve as a screening tool in assessing fetuses of high risk obstetric patients in hospitals/centers with a heavy workload and limited resources.