The incidence of abnormal findings from intrapartum cardiotocogram monitoring in term and preterm labours.
A retrospective analysis of 514 consecutive labours delivering 530 babies over a period of 18 months was conducted by a high-risk pregnancy team in a tertiary teaching unit to compare the incidence of abnormal findings from intrapartum monitoring between labours occurring before and at or after 34 weeks' gestation. Those delivered by elective Caesarean section, or Caesarean section at the onset of labour because of contraindications to labour and vaginal delivery, and those with congenitally malformed fetuses were excluded. Tracings were scored using the FIGO 1987 guidelines. Seventy-four labours and 83 babies delivered before 34 weeks, and 440 labours and 447 babies delivered after 34 weeks in the study. There was a slightly higher incidence of suspicious CTG tracings (33.7% versus 19.6%, OR 2.66, 95% CI 1.6-4.4) in the preterm group, due mainly to decreased baseline variability (p<0.001, OR 3.57, 95% CI 1.8-6.9), but the incidence of other pathological patterns did not differ. Using the same set of criteria for interpretation, there was a higher incidence of abnormalities from continuous cardiotocogram monitoring in the preterm group compared to term labours, but the intervention rate for fetal distress was not significantly increased. Appropriate interpretative criteria for intrapartum monitoring of preterm labours should be devised.
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Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong, China.
Leung
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WC
D000328:Adult; D015148:Cardiotocography; D002585:Cesarean Section; D005260:Female; D005316:Fetal Distress / Q000503:physiopathology; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D018566:Pregnancy, High-Risk; D011272:Pregnancy, Multiple; D012189:Retrospective Studies