Cardiotocography (CTG) as the screening method of fetal condition assessment

A basic function of fetal monitoring is an analysis of fetal cardiac action. Cardiotocography (CTG) cannot provide all necessary information for assessment of the fetal condition as it is not sufficiently reliable and gives a large number of false positive results that increase the number of cesarean sections. An objective of this work was to establish CTG reliability as a method for assessment of intrapartal fetal condition. Based on CTG parameters (baseline fetal heart rate, fetal heart rate variability, oscillations and decelerations) 100 pathological CTG records, collected at Obstetrics and Gynecology Department of the Tuzla University Clinic Hospital from 01.12.2004 to 05.08.2005 were identified. Using binomial distribution they were classified as non-pathological (indicating absence of asphyxia) and pathological (indicating possible presence of asphyxia). After the delivery the condition of newborns was assessed according to the Apgar score. Based on comparison between certain pathological parametres of CTG records and newborns’ conditions at birth the results indicated high positive predictive values whereas sensitivity and accuracy were low. Apgar score 1. from 7 upwards was given to 96 (96%) newborns whereas Apgar score 2 from 7 upwards was given to all the newborns with previous pathological CTG records. Results have confirmed that CTG can be used only as a screening method for assessment of intrapartal fetal condition.