Association of Abnormal Intrapartum Cardiotocograph with Abnormal Umbilical Cord pH in Term Pregnant Women
DOI:
https://doi.org/10.51985/Keywords:
Cardiotocography, umbilical cord pH, fetal acidemia, term pregnancy, intrapartum monitoringAbstract
Objective: To determine the frequency of abnormal intrapartum cardiotocography (CTG) and its association with abnormal umbilical cord arterial pH in term pregnant women.
Study design and setting: Descriptive longitudinal study conducted in the Department of Gynaecology and Obstetrics, Dow University Hospital, Karachi.
Methodology: A total of 178 term pregnant women (37–41 weeks), aged 20–45 years with gravidity and parity =1, were enrolled using non-probability consecutive sampling. Continuous intrapartum CTG was performed and classified according to prespecified criteria. Women with abnormal CTG received conservative measures according to ward protocol, followed by repeat CTG after 30 minutes. Umbilical cord arterial blood was collected immediately after birth for pH analysis; cord pH <7.2 was classified as abnormal. Data were analyzed using SPSS version 22.
Results: Abnormal intrapartum CTG was observed in 24/178 women (13.5%). Overall, abnormal umbilical cord arterial pH (<7.2) occurred in 18/178 neonates (10.1%). Abnormal cord pH was present in 11/24 neonates (45.8%) after abnormal CTG compared with 7/154 (4.5%) after normal CTG (p<0.001). Late decelerations and reduced variability showed the highest proportions of abnormal pH among the abnormal CTG patterns, although subgroup analyses were limited by small cell counts.
Conclusion: Abnormal intrapartum CTG occurred in 13.5% of term pregnancies and was significantly associated with abnormal umbilical cord arterial pH (<7.2). Cord arterial pH provides an objective biochemical measure that can complement CTG interpretation at birth
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