Abstract: Background: Cardiotocography (CTG) is widely used for foetal monitoring during pregnancy and labour to assess foetal well-being and predict adverse perinatal outcomes. This study evaluates the role of Cardiotocography in predicting foetal outcomes in both high-risk and low-risk pregnancies.
Methods: A cross-sectional study was conducted on 200 pregnant women in labour admitted to a tertiary care center. Participants were categorized into high-risk (N=95) and low-risk (N=105) groups based on obstetric history and clinical parameters. CTG results were classified as normal, suspicious and pathological. Outcomes were measured which included mode of delivery, foetal distress, meconium stained, Apgar scores, resuscitation needed, NICU admissions and duration of hospital stay.
Results: Age Distribution: Participants were primarily young adults, with a mean age of 24.11 years (SD = 3.37). Gestational Age: Mean gestational age was 38.475 weeks (SD = 0.8572).
Risk Categories: 47.5% (N=95) of participants were high-risk, and 52.5% (N=105) were low-risk.
CTG Results: 29% (N=58) had pathological (ominous) CTG results, 60% (N=120) were normal, and 11% (N=22) were suspicious.
Mode of Delivery: Cesarean sections were performed in 30.5% (N=61), instrumental deliveries in 18.5% (N=37), and normal vaginal deliveries in 51% (N=102). Pathological CTG results were significantly associated with a higher rate of cesarean sections (46.6%).
Perinatal Outcomes: Pathological CTG results correlated with lower Apgar scores at 1 and 5 minutes, higher NICU admissions and prolonged hospital stays. For example, pathological CTG results were associated with an Apgar score of 6.47 at 1 minute and 7.19 at 5 minutes compared to reactive CTG results (Apgar scores of 8.07 and 8.52, respectively).
Statistical Analysis: Significant associations were found between CTG results and mode of delivery (P=0.001), foetal distress (P=0.001) and NICU admissions (P=0.001).
Conclusions: CTG is a valuable tool in predicting perinatal outcomes in both high risk and low risk categories, particularly in high-risk pregnancies. Pathological CTG results are strongly associated with adverse outcomes such as lower Apgar scores, increased NICU admissions and higher rates of cesarean sections. These findings underscore the importance of CTG in the management and decision-making process in high-risk pregnancies.
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