Abnormal CTG and Its Perinatal Outcome

Cardiotocography is simple, non ivasive and cost effective way to asess both antepartum and intrapartum fetal health.Although a normal pattern is very reassuring about fetal condition predictive value of abnormal pattern is low.The use of Cardiotocography is associated with increase in intervention like Cesarean section as in this study abormal Cardiotocography leads to 51% that is 102 patient had cesarean section in 200 patients.There was also correlation between liquor color and abnormal cardiotocography, presence of meconium stained liquor and blood stained liquor as in Abruption is associated with need for neonatal resuscitation. Cardiotocography does not identify the fetuses at risk, As in this study only 10% that is out of 200 abnormal cardiotocography only 20 neonates needed Level 3 admission and had severe birth asphyxia ;41 neonates needed only observation, 92 neonates were mother side and 42 neonates admitted in level 2 with mild to moderate birth asphyxia.Hence there is need for additional approaches like fetal scalp blood sampling, Fetal pulse oximetry, ST waveform analysis, fetal scalp lactate analysis to identify acidosis for fetal which is not routinely done. Hence labour should be assessed on individual basis with which we can reduce PERINATAL morbidity and death in India particularly in Tamilnadu. LIMITATIONS: • This is an observational study hence inter-observer and intra-observer bias cannot be ruled out. • As this study was done in the tertiary care center with availability of CTG monitoring for all the patients and round the clock availability of operation theatre, this cannot be extrapolated to the medical centers where these facilities are not available. • The cord pH was not done universally for all the babies, whose mothers were included in this study because of financial constraints. It was only done where neonates who required positive pressure ventilation as a resuscitative measure. • This study did not include long term follow up therefore complications like poor school performance, mental retardation, cerebral palsy could not be commented upon