Admission test in detecting fetal asphyxia at the time of admission in labour

Introduction: The intrapartum assessment of fetal well being has become an integral part of the management of labour. Aim: The objective of this study was to evaluate the predictive value of admission test in detecting fetal asphyxia at the time of admission in labour and to correlate the results of admission test with perinatal outcome in high risk obstetric cases compared with low risk obstetric cases. Materials and methods: This was a prospective observational study conducted in the labour and maternity ward of Govt. Gandhi hospital in Secunderabad, during the period 2012 to 2013 with a sample size 50 high risk obstetric cases and 50 low risk obstetric cases. All women were subjected to an admission CTG, which included a 20 minute recording of FHR and uterine contractions. Results: The majority of women were primigravida in the 18-23 years age group in both high risk and low risk groups. Admission test was reactive in 35 cases (70%) in high risk group, 42 cases (84%) in low risk group where as non reactive in 15 cases (30%) in high risk group and 8 cases (16%) in low risk group. In cases with reactive admission test spontaneous vaginal deliveries were more in low risk group than in high risk group. Operative deliveries were more in high risk group than in low risk group in both reactive and non reactive admission test. Indication for caesarean section in both reactive and non reactive admission test was more in high risk group i.e. 1 case (25%) and 6 cases (66%) respectively. Perinatal outcome was abnormal in high risk groups in both reactive and non reactive admission test. Specificity and Negative predictive value in high risk group is less than that in low risk group. Conclusion: The admission CTG appears to be a simple non-invasive test that can serve as a screening tool in both high-risk and low risk obstetric patients with significant results.