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Research Paper | Obstetrics and Gynecology | India | Volume 14 Issue 4, April 2025 | Popularity: 5.9 / 10
Correlation of Cardiotocography with Intraoperative Findings in Caesarean Section for Non-Reassuring Fetal Status and Neonatal Outcomes in Rural Tertiary Care Center: A Cross-Sectional Observational Study
Ravali Nichanametla, Vimarshitha P
Abstract: Background: Cardiotocography (CTG) has been a pivotal tool in obstetric monitoring since its introduction in the 1970s, enabling continuous assessment of fetal heart rate (FHR) and uterine contractions. While CTG aims to detect fetal hypoxemia and asphyxia early, its interpretation can sometimes lead to an increased rate of caesarean sections for non - reassuring fetal status (NRFS). This trend raises concerns about the balance between necessary medical interventions and the risk of unnecessary surgical deliveries, especially in resource - limited rural tertiary care settings. Aim: The primary aim of this study was to evaluate the correlation between CTG findings and intraoperative observations in pregnant women undergoing emergency C - sections for NRFS at a rural tertiary care centre. Additionally, the study sought to assess the associated neonatal outcomes to determine the accuracy and impact of CTG - based decision - making on both maternal and neonatal health. Methods: A cross - sectional observational study was conducted at RL Jalappa Hospital and Research Centre, affiliated with Sri Devaraj Urs Medical College, Tamaka, Kolar, over a duration of one year. The study included 42 pregnant women with singleton pregnancies between 32 to 40 weeks of gestation who underwent emergency C - sections due to NRFS as indicated by CTG. Participants with multifetal pregnancies, non - cephalic presentations, gestational age below 32 weeks, and significant medical disorders during pregnancy were excluded. Data were collected using structured case record forms and analysed using SPSS Software version 26. Descriptive statistics, chi - square tests, t - tests, and ANOVA were employed to analyse the data, with a significance level set at p < 0.05. Results: The mean age of participants was 24.14 years (SD = 4.604), and the average neonatal weight was 2.86 kg (SD = 0.440 kg). A majority of the women were primigravida (42 cases, 76.2%). Gestational age at delivery was predominantly between 38 to 40 weeks (30 cases, 71.4%). Intraoperative findings revealed that 38.1% of cases had " liquor thick meconium stained, " indicating significant fetal distress. Apgar scores at 1 minute were predominantly 1?7/10 (85.7%), improving to 5?9/10 at 5 minutes in 83.3% of neonates. Neonatal outcomes showed that successfully managed without NICU admission at 64.3% (N=27), required observation (Obs) at 19.0% (N=8), and experienced respiratory distress (RD) at 14.3% (N=6). Conclusion: The study demonstrated a significant correlation between CTG findings and intraoperative observations, with a majority of neonates achieving favorable Apgar scores. However, the presence of respiratory distress and stillbirths in a subset of cases highlights the necessity for precise CTG interpretation and timely medical interventions. These findings suggest that while CTG is effective in identifying fetal distress, enhancing training and implementing standardized guidelines could reduce unnecessary C - sections and improve neonatal outcomes, particularly in rural tertiary care settings.
Keywords: Cardiotocography, Non - reassuring fetal status, Caesarean section, Neonatal outcomes, Rural tertiary care
Edition: Volume 14 Issue 4, April 2025
Pages: 561 - 568
DOI: https://www.doi.org/10.21275/SR25404222124
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