Admission cardiotocography: Forecasting perinatal outcome

Abstract

The Admission test (AT) in high risk pregnancy for continuous monitoring of FHR (fetal heart rate) has become crucial in the modern day obstetric practice. As it senses the presence of fetal intrapartum hypoxia and assist the obstetrician in making decision on the mode of delivery to improve perinatal outcome in high risk pregnancy.A prospective observational study was carried out in 230 pregnant women with high risk pregnancy in KIMS BBSR, Odisha during period of 2018-2020 who were admitted to labor room with gestational age more than 33 weeks for continuous FHR monitoring with CTG (cardiotocography) for 20 minutes.Among 230 patients majority of them were primigravida in age group of 21-25 years. About 39.1% were postdated pregnancy followed by Pregnancy Induced Hypertension (PIH) (21.1%), Premature Rupture of the Membranes (PROM) (10.4%), Bad Obstetric History (BOH) (6.9%), PIH with IUGR (Intrauterine Growth Restriction) (6.5%), IUGR (5.6%), Oligohydramnios (4.3%), Diabetes (3.5%) and Rh negative pregnancy (2.6%). The admission test were normal in (68.7%), suspicious in (21.7%) and pathological in (9.6%). The incidence of fetal distress, meconium stained liqour, NICU (Neonatal Intensive Care Unit) admission and APGAR score less than 7 was significantly higher with pathological AT as compared with suspicious and normal AT.The admission CTG appears to be simple noninvasive tool for screening the high risk pregnancy and prioritizing fetuses and deciding the mode of delivery.