Is the Admission Cardiotocography Test Predictive of an Emergent Cesarean Delivery During Labor in Prolonged Pregnancies?

Abstract

Background: The aim of the study was to evaluate if an admission cardiotocography (CTG) test presenting with an indeterminate fetal heart rate tracing (FHR) was predictive of an emergent cesarean delivery during labor at or after 41 weeks.

Methods: This was a retrospective cohort study of women who delivered>=41 weeks between January 1, 2019 and December 31, 2019. Admission test was performed during the first 20 min, upon entry into the department in the event of spontaneous labor, or at the beginning of induction of labor. Multivariate logistic regression was performed to evaluate an indeterminate FHR during the admission test in the prediction of emergent cesarean delivery during labor controlling for potential covariables.

Results: Normal and indetermediate FHRs were detected in 260/335 (77.6%) and 75/335 (22.3%) of the cases, respectively. There were significantly more emergent cesarean deliveries during labor for FHR abnormalities in the indeterminate group compared to the normal group (22/38 (57.9%) vs. 24/27 (88.9%), P = 0.02). An indeterminate FHR increased the risk of emergent cesarean delivery during labor by 3.47 times (95% confidence interval: 1.8 - 6.5, P < 0.01).

Conclusion: An indeterminate FHR during the admission test>=41 weeks increased the risk of emergent cesarean delivery during labor.

J Clin Gynecol Obstet. 2022;11(1):9-13
doi: https://doi.org/10.14740/jcgo791