The Correlation Between Antenatal Cardiotocography And Apgar Score, Perinatal Outcome.

Irshad Ahmad Tali; Manzoor Ahmad Tali; Hilal Ahmad Tali

Volume : VIII, Issue : XII, December - 2019

The Correlation Between Antenatal Cardiotocography And Apgar Score, Perinatal Outcome.

Irshad Ahmad Tali, Manzoor Ahmad Tali, Hilal Ahmad Tali

Abstract :

mother.Cardiotocography as generally accepted, and is most widely used non–invasive method of monitoring fetal status.There is significant correlation between pathological CTG and the state of the newborn evaluated by Apgar score, the existence of acidosis,hypoxic–ischemic encephalopathy and subsequent neuromotor development.Cardiotocography (CTG) is an electronic fetal monitoring which records fetal heart rate and uterine activity on a graph. AIMS AND OBJECTIVES To evaluate the correlation between antenatal CTG and Apgar score at 0, 1 and 5 minute and perinatal outcome. MATERIAL AND METHODS This prospective observational study in which 300 women with gestational age of 37–42 weeks with singleton pregnancy with or without any comorbidity were included.Women included in the study underwent CTG at the time of admission and during labour.The cardiotocogram was interpreted as per FIGO guidelines and were allocated the three categories.Afgar score was calculated at birth 0 ,1,and 5 minutes and correlated with CTG category.The need for neonatal intensive care unit (NICU) admission were correlated with the type of CTG record. STATISTICAL ANALYSIS Relationship between antenatal CTG and APGAR at birth,1 min and 5 min were analyzed using Kniskallwallis test. Two tailed p–values was reported and a p–value <0.05 was taken as statistically significant. RESULTS Majority of patients i.e. 197 (65.7%) belonged to the age group of 30–34 years. Majority of cases i.e. 91 (30.2%) had gestational age of 40 weeks.Patients were divided into three categories. 109 (36.3%) patients fall in category I, 107 (35.6%) in category II, and, 84 (28%) in category III.When CTG was correlated with apgar score at birth, patients with apgar score of 1–3 were 1 (0.9%) in CTG category I, 30 (38%) in CTG category II and 81 (96.4%) in CTG category III. At apgar score of 4–6 there were 22 (20.2%) in CTG category I, 71 (66.4%) in CTG category II and 3 (3.6%) in CTG category III, and when the apgar score was > 7, there were 86 (78.9%) in CTG category I, 6 (5.6%) in CTG category II and none in CTG category III. The results were statistically significant with a p value of <0.001.When CTG was correlated with apgar score at 1 min, patients with apgar score of 1–3 were 1 (0.9%) in CTG category I, 8 (7.5%) in CTG category II and 43 (51.2%) in CTG category III. At apgar score of 4–6 there were 3 (2.8%) in CTG category I, 81 (75.7%) in CTG category II and 41 (48.8%) in CTG category III, and when the apgar score was > 7, there were 105 (96.3%) in CTG category I, 18 (16.8%) in CTG category II and none in CTG category III.The results were statistically significant with a p value of <0.001.When CTG was correlated with apgar score at 5 min, patients with apgar score of 1–3 were 1 (0.9%) in CTG category I, 3 (2.8%) in CTG category II and 16 (19.0%) in CTG category III.At apgar score of 4–6 there was no patient in CTG category I, 17 (15.9%) in CTG category II and 47 (56.0%) in CTG category III, and when the apgar score was > 7, there were 108 (99.1%) in CTG category I, 87 (81.3%) in CTG category II and 21 (25%) in CTG category III. The results were statistically significant with a p value of <0.001. Conclusion Cardiotocography (CTG) is a simple noninvasive test that can be used to detect fetal distress already present or likely to develop and prevent unnecessary delay in intervention. Thus it helps in preventing fetal morbidity and mortality. This test is simple, cost effective and can be utilized in heavy work load hospital/setups with limited resources. With the use of CTG in high risk cases timely intervention can be implied to reduce the perinatal mortality and morbidity.