Role of Cardiotocography in Predicting Intrapartum Asphyxia, taking Apgar Score and Physical Examination as Gold Standard

Objectives

To determine the positive predictive value of cardiotocography in predicting intrapartum asphyxia, taking APGAR score and physical examination as the gold standard. Methodology: 383 total pregnant women aged between 18 and 40 years at term were included in the study. To properly calculate positive predictive value (which requires both positive and negative test results), the study included women with both abnormal and normal CTG findings. Abnormal CTG findings were characterised by baseline variability (<5 bpm) lasting more than ninety minutes, baseline FHR exceeding 180 beats per minute or falling below 100 bpm, and significant variable decelerations or late decelerations, with a depth greater than 60 bpm and duration exceeding 60 seconds. Patients’ females with previous miscarriage (as per history and clinical record) or having cord around the neck or placenta previa as per obstetrical scan were excluded. The neonates delivered were examined by the consultant of the Paediatrics Department. The APGAR score and physical examination were done. All CTG recordings were interpreted by a single consultant gynaecologist by using the same machine. Cases of intrapartum asphyxia were identified based on CTG findings, APGAR scores, and relevant physical examination results.