Admission test as precursor of perinatal outcome: a prospective study.
OBJECTIVE
To test the reliability of the admission test to identify the compromised fetus and thus reduce the neonatal morbidity and mortality by early intervention.


METHODS
A prospective analysis over a period of 1 year from December 2007 to December 2008 included 100 antepartum patients and were evaluated for perinatal outcome in two groups.


RESULTS
In both low and high risk groups the incidence of meconium staining was 25 and 37.5% in patients with nonreactive traces as compared to 8.6 and 9.5%, respectively, in reactive traces with specificity of 90.9%. Clinically detected fetal distress was more common in patients with nonreactive test. Operative interference for fetal distress was more in patients with nonreactive test. Occurence of low Apgar score was more in patients with nonreactive test. Admission to neonatal unit was more in nonreactive than reactive traces. Incidence of neonatal death was more in nonreactive test. Incidence of low birth weight was more in nonreactive trace group and more so in high risk group than in low risk group.


CONCLUSIONS
Admission test may be best recommended in all patients irrespective whether they are in low or high risk as incidence of neonatal morbidity is high 33.3% babies required NICU admission and 33% babies expired in nonreactive tracing, in centers where advance facilities are not available. Whenever there is a nonreactive tracing further test should be carried out.
Khandelwal
Shivani
S
Department of Gynecology and Obstetrics, Herbertpur Christian Hospital, Dehradun, India. drshivani6@gmail.com
Dhanaraj
Mitra
M
Khandelwal
Atul
A
D001034:Apgar Score; D005260:Female; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D007363:Intensive Care Units, Neonatal; D010343:Patient Admission; D054238:Perinatal Mortality; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012307:Risk Factors