Maternal and Fetal Outcome of Normal and Abnormal Cardiotocographic Findings at A Tertiary Hospital in Ghana

Abstract

Background: Cardiotocography (CTG) provides important information about the interaction between fetal cerebral and cardiac activities which are both modified by hypoxia. The duration and severity of hypoxia and associated biochemical abnormalities all
influence the manifestations of fetal heart rate abnormalities. Antenatal fetal heart rate monitoring with CTG has potential in preventing intrauterine fetal death.
Aim: The aim of the study was to compare the maternal and fetal outcome of pregnancies with normal and abnormal antepartum CTG tracings.
Methodology: This descriptive retrospective review compared 200 consecutive women with normal and 200 with abnormal CTG tracings. The study lasted six months and spanned a period of time from beginning of January to end of June 2011. Demographic, pregnancy and delivery outcome data were retrieved from participants' charts and simple descriptive analysis was performed. Means and their standard deviations of continuous variables were calculated and difference between group mean were compared using the student test. Categorical variables were summarized as proportions and the chi-square test used to test for difference between groups. A p-value < 0.05 was considered statistically significant.
Results: Women with normal and abnormal CTG tracings were comparable in their demographic characteristics. Abnormal CTG tracings were associated with higher rate of preterm delivery (38.8% vs 18.8%, p = 0.001), caesarean section (77.9% vs 47.0%, p = 0.001)
low birth weight (25.5% vs 9.1%, p = 0.001) and NICU admissions (36.5% vs 17.6%, p = 0.001). There was no difference in Apgar score or stillbirth rate between the two groups. Pregnancies with abnormal tracing were delivered about a week earlier than those with normal
tracing. (37.8±2.9 vrs 38.3±2.6, p=0.001). Longer interval between tracing and delivery was associated with stillbirth.
Conclusion: Abnormal antepartum CTG tracing was associated with higher preterm delivery, caesarean section, low birth weight and NICU admission. Longer interval between abnormal tracing and delivery was associated with higher stillbirth rate. Active and adequate resuscitation of babies with abnormal tracing can reduce perinatal morbidity.