Al Ameen Journal of Medical Sciences (Apr 2024)
Evaluation of perinatal and maternal outcomes by using EFM and admission CTG in a tertiary care center
Abstract
Background: Electronic foetal heart rate monitoring (EFM) using cardiotocography (CTG) is crucial for assessing foetal well-being during labour and aiding in the early detection of intrapartum hypoxia. Admission CTG, short-term monitoring upon labour ward entry, identifies high-risk factors and guides subsequent interventions to prevent perinatal morbidity and mortality. Methods: A cross-sectional study conducted at Al Ameen Medical College and Hospital from August 2022 to July 2023 included booked and unbooked antenatal patients in latent labour. The study included 950 women in the first stage of labour in the low-(n=550) and high-risk (n=400) groups based on identified risk factors. Perinatal outcomes were assessed, including mode of delivery, liquor colour, APGAR scores, and NICU admissions. Results: High-risk factors such as hypertensive disorders (20%), anaemia (23.75%), gestational diabetes (6.25%), previous LSCS (37.50%), and post-date pregnancies (32.25%) were prevalent in the high-risk group. The majority of the participants were aged 20–30 years (52.7%), booked (39.2%), and presented at gestational ages ≥37 to <40 weeks (47.2%). Reactive CTG patterns were predominant in low-risk pregnancies (83.47%) and correlated with favourable perinatal outcomes. Equivocal and non-reactive CTG patterns in high-risk pregnancies were associated with compromised neonatal well-being, as evidenced by lower APGAR scores, increased resuscitation needs, higher NICU admissions, and perinatal deaths. Conclusion: Reactive CTG patterns are associated with positive perinatal outcomes, whereas equivocal and non-reactive patterns indicate heightened risks. Integrating risk stratification and CTG monitoring into obstetric protocols can enhance decision-making precision and improve the outcomes for both mothers and infants. This study highlights the need for further research on maternal risk management.
