Saadia Ghafoor, Muhammad Al Fareed Zafar.
Comparison of pathological versus suspicious cardiotocography in predicting fetal distress in terms of apgar score and umbilical cord ph at one minute on caesarean section.
Pak Postgrad Med J Jan ;34(3):121-4.

Background:Cardiotocography(CTG) has been used widely in recent decadeto reduce intra-partum fetal mortality.Pathological CTG is more accurate in predicting fetal distress in term of APGAR score and umbilical cord blood PH.Objective: To determine difference in fetal out come in terms of APGAR score and cord pH at one minute in pathological compare to suspicious CTG. Methods: This comparative analytical study was carried out at as Obstetrics and Gynecology Department, Lahore General Hospital, Lahore in duration of six months after approval of ethical committee. We included 454 antenatal patients in our research which were divided in two groups: group-A (Pathological trace) and group-B (Suspicious trace) i.e. 227 in each group. All infants were observed for neonatal outcome as were admitted in neonatal ICU and APGAR score < 7 and umbilical cord pH at one minute. Results: The mean age of all participating pregnant females was 28.86 +- 6.56 years while the mean age in group-A (Pathological trace) and group-B (Suspicious trace) was 29.34 +- 6.56 years and 28.38 +- 6.54 years, respectively, with insignificant p-value of 0.119 (i.e > 0.05). In groups A and B, the proportion of babies with an APGAR score of less than 7 was 80.6 % and 5.7 %, respectively, p-value <0.001. The NICU admission rate in group-A (77.1%) was higher than in group-B (9.3%), p-value< 0.001 and umbilical cord pH at one minute after delivery was 89.4% in group A, 15% in group B and P value < 0.001.Conclusion: When compared to suspicious CTG, pathologically trace showed a higher rate of APGAR score less than 7, fetal distress, and admission to neonatal ICU. Moreover, pathological CTG trace has higher predictive accuracy for neonatal outcome such as fetal distress, APGAR score < 7 and admission to NICU and umbilical cord blood pH.

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