Cardiotocography as a predictor of fetal outcome in women presenting with reduced fetal movement.

Abstract

OBJECTIVE:

To examine the obstetric and perinatal outcomes of women presenting with reduced fetal movement (RFM) during the third trimester, specifically in relation to the diagnostic capacity of non-stress cardiotocography (CTG) used as the primary investigation in this clinical scenario.

STUDY DESIGN:

This was a retrospective population-based cohort study of pregnancy outcomes of all women ≥ 28 weeks' gestation with singleton pregnancies presenting during one calendar year with maternal perception of RFM, all of whom underwent CTG at presentation. Main outcome measures included: obstetric intervention (induction of labour, spontaneous vaginal delivery, operative vaginal delivery, emergency caesarean section), and perinatal outcome (subsequent perinatal death, low Apgar scores (<7(5)), neonatal resuscitation and NICU admission).

RESULTS:

In all, 524 women presented with RFM and a live fetus, representing 7% of the antenatal obstetric population; 284 women (54%) were nulliparous. The reassuring CTG group comprised 482 (92%) women in whom initial CTG was reassuring and 15 (3%) where a repeat tracing within 1h was reassuring. The non-reassuring/abnormal CTG group (n=27, 5%) either underwent emergency delivery or comprehensive serial fetal assessment; this group had significantly higher rates of emergency caesarean delivery, neonatal resuscitation and NICU admission; the incidence of small-for-gestational-age infants did not differ significantly. No perinatal death occurred in either group following CTG.

CONCLUSION:

Normal non-stress CTG is a reliable screening indicator of fetal wellbeing in women presenting with perception of RFM in the third trimester; abnormal pregnancy outcomes were more common when initial CTG was abnormal or persistently non-reassuring.

• Authors: Niamh Daly, Donal Brennan, Michael Foley, Colm O'Herlihy
• Journal: European journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 159 Issue 1 Pg. 57-61 (Nov 2011) ISSN: 1872-7654 [Electronic] Ireland
• PMID: 21899943 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2011. Published by Elsevier Ireland Ltd.

Topics

• Apgar Score
• Cardiotocography
• Cesarean Section
• Cohort Studies
• Cross-Sectional Studies
• Female
• Fetal Distress (diagnosis, epidemiology, physiopathology, therapy)
• Fetal Movement
• Heart Rate, Fetal
• Humans
• Infant, Newborn
• Intensive Care Units, Neonatal
• Ireland (epidemiology)
• Male
• Medical Records
• Pregnancy
• Pregnancy Outcome
• Pregnancy Trimester, Third
• Prenatal Diagnosis (methods)
• Resuscitation
• Retrospective Studies