Citation Information :
Kanagal DV, Praveen B. Intrapartum Fetal Monitoring and Its Correlation with Umbilical Cord Blood pH and Early Neonatal Outcome: A Prospective Cohort Study. J South Asian Feder Obs Gynae 2022; 14 (1):63-67.
Aim: Intrapartum fetal hypoxia leads to neonatal morbidity and mortality. Though cardiotocography (CTG) plays an important role in detecting fetal hypoxia, it has high false-positive rate and is a poor predictor of acidosis. Umbilical artery pH identifies infants at risk for hypoxia and better predicts neonatal outcome. Hence the study was done to correlate nonreassuring CTG findings with umbilical artery pH and neonatal outcome.
Materials and methods: The study included 255 pregnant women in labor with nonreassuring CTG. The findings were categorized as suspicious and pathological. Umbilical arterial cord blood analysis was done in all newborns. The umbilical arterial cord blood pH of <7.2 was defined as fetal acidosis. The correlation between CTG findings, cord blood pH, and neonatal outcome was recorded.
Results: In the study, among 255 women, 54.9% had suspicious and 45.1% had pathological CTG. The rate of cesarean section, Apgar score, was similar in both the groups. Subjects with pathological CTG had more babies with low cord pH compared to suspicious CTG (62.6 vs 26.4%). 55% of babies with pH <7.2 needed neonatal intensive care unit (NICU) admission compared to 11.6% with normal pH. Babies born with pathological CTG and low cord pH were more likely to have NICU admission and other morbidities.
Conclusion: Detection and management of fetal compromise at the earliest is of utmost importance. Though cardiotocography is a simple test to analyze fetal condition, it is a good practice to analyze umbilical cord blood pH to find neonates with acidosis and prevent complications.
Clinical significance: The umbilical artery pH is a good predictor of adverse neonatal outcome and is a useful tool for screening newborns at risk. Also an umbilical cord pH less than 7.2 can be used as a prognostic factor for prediction of neonatal outcome. Our study is one of the very few studies that compare CTG findings based on National Institute for Health and Care Excellence (NICE) guidelines with umbilical artery pH and neonatal outcome.
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