Association between CTG Parameters One Hour before Delivery and Neonatal Asphyxia
DOI:
https://doi.org/10.37506/r90vh961Abstract
Background: Cardiotocography (CTG) is a vital tool in obstetric practice for real-time fetal monitoring. However, its predictive value in identifying neonatal asphyxia remains underexplored, particularly in the critical hour before delivery.
Aim of the Study: This study investigates the association between CTG monitoring in the last hour before delivery and neonatal asphyxia, aiming to evaluate its predictive value.
Patients and Methods:This study is a descriptive retrospectivecohort study conducted at Al-Elwiya Maternity Teaching Hospital between January 2024 and January 2025. The study included 250 pregnant women presented with labourcondition to the mentionedhospital, CTG monitoring was applied continuously. After delivery (whether by vaginal delivery or caesarean section)CTG of last hour before delivery was compared for the neonates who had asphyxia and those without asphyxia. Inclusion criteria were: Term months, no history of taking drug, before delivery that affects the heart rate of the foetus (as magnesium sulphate, narcotics and pain killers), no history of fever, no history of drugs, addition, not smoker, not alcoholic, babies without congenital anomalies. Exclusion criteria: Preterms, mothers with medical disease like diabetes mellitus and hypertension,addiction to smoking and alcohol, mothers taking drugs that affect the heart rate of the focus like (magnesium sulphate, narcotics and pain killers, maternal fever, neonates with congenital anomaly, extremes of reproductive age group and extremes of BMI (<18.5 or ≥ 25 kg/m2).
Results: Pathological CTG patterns were observed in 70% of the asphyxia group, compared to 1.6% in the non-asphyxia group. Late decelerations, absent variability, and accelerations were significantly associated with asphyxia. Caesarean delivery was more common in the asphyxia group. The need of NICU admissions further emphasized the poor neonatal outcomes.
Conclusion: CTG monitoring in the last hour before delivery shows significant predictive potential for neonatal asphyxia. Specific CTG patterns can guide timely obstetric interventions, which can lead to improve neonatal outcomes.
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