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PubMed1984

Antenatal cardiotocography in the evaluation of fetal well-being.

Antenatal fetal heart rate monitoring is a reliable tool to detect the fetus at risk. In the interpretation of records, however, due account must be taken of maturation and fetal behavioural status. In this article the normal heart rate pattern throughout gestation is described. Visual quantitative and descriptive scoring systems are compared and the consequences of interobserver variability in assessing antenatal heart rate records are discussed. It is postulated that there is only a small--if any--place for oxytocin stress testing. Finally the clinical implications of the different fetal heart rate patterns are presented.

Female↗
PubMed1982

Predictive value of a single unstressed antepartum cardiotocogram in apparently uncomplicated pregnancy. Introduction of a new cardiotocography score.

Antepartum CTGs were recorded in 88 pregnant women in the 36th week of pregnancy, approximately. The CTGs were evaluated according to three different CTG scoring systems. A new CTG score in now presented. The three systems are compared according to their ability to predict retarded intra-uterine growth. Nine infants were born small-for-date; 8 of these had suspect CTG. In 7 of these cases reduced variability was present for more than 25% of the registration time. When variability is reduced for more than 25% of the registration time there is a statistically significantly higher rate of infants born small-for-date (p less than 0.001). Fifty per cent of those fetuses that did no move spontaneously during registration were born small-for-date. When accelerations were present, 94% of the infants were born normal-for-date. Low estriol and/or low hPL levels were found in 5 of 9 cases where the infants were born small-for-date. Low estriol/hPL and/or suspect CTG were found in all cases of infants born small-for-date. When estriol, hPL and CTG were normal, no infants were born small-for-date.

Female↗
PubMed1982

Significance of unstressed antepartum cardiotocography performed weekly in last trimester of apparently normal pregnancy.

Antepartum Cardiotocographs (CTGs) were obtained at weekly intervals from 28th-30th week of pregnancy onwards in 111 apparently normal pregnancies. A new CTG score was used to assess the 1196 CTGs obtained, 80 per cent of which proved normal. Minor pathology was seen in 19.1 per cent, while moderate or severe pathology was seen in only 0.9% of the CTGs. Of 16 babies born small-for-date, 15 had a pathological CTG on one or more occasions. There was a significantly greater incidence of small-for-date infants when two or more pathological CTGs were observed. Nineteen of 20 women whose babies developed late decelerations during labor had at least one pathological CTG. All infants with an Apgar score less than 5 and all acidemic fetuses had one or more pathological CTGs. All women who required cesarean section because of fetal distress during labor had pathological CTGs on two or more occasions. All cases in which accelerations of the fetal heart rate did not accompany movements (AFM) after the 36th week of pregnancy resulted in the birth of a small-for-date infant, while sporadic absence of AFM before the 36th week was of no importance.

Adult↗
PubMed1984

Unstressed antepartum cardiotocography in the management of pregnancies complicated by intrauterine growth retardation.

A study of antenatal cardiotocographs (CTG) in 250 patients with fetal growth retardation showed that nonreactive tracings were associated with a significant increase in operative deliveries for fetal distress in labour, a high perinatal mortality rate, and fetal anomalies, and a low Apgar score of the infant, both at one and five minutes after delivery. A "ten-point" scoring system was used to evaluate the CTG tracing. A score of 6 or less was associated with a significantly higher perinatal morbidity and mortality rate compared with those who had a score of 7 or more (p less than 0.01).

Apgar Score↗