TO STUDY THE CATEGORY II CARDIOTOCOGRAPHY AND ITS CORRELATION WITH UMBILICAL CORD PH

Introduction: The purpose of intra-partum fetal monitoring is to identify early signs of developing hypoxia. Electronic fetal monitoring is performed using cardiotocograph, which is a paper record of the fetal heart rate (FHR) patterns plotted simultaneously in relation to uterine activity. In low resource settings umbilical cord artery blood gas analysis can provide important information about the fetuses exposed to intrapartum hypoxaemic events and can distinguish the infant at high risk for asphyxia and related sequelae. The aim of this study was to correlate intrapartum CTG findings with umbilical cord blood pH at birth in term pregnancies in labour and thus evaluate the success of CTG in predicting fetala cidosis during labour. Methods:The present study included 100 women with term singleton pregnancies in labour and with Category II according to NICHD 2008 Classification (Adapted by ACOG 2013). Umbilical cord arterial blood was taken immediately after birth, in a pre-heparinised syringe and sent to the laboratory for pH study to detect acidosis. Cord blood pH <7.2 was taken as acidosis and cord blood pH ≥7.2 was taken as normal Results: Among 100 patients, 78 had normal cord pH and 22 had abnormal cord pH(<7.20). On intrapartum CTG, maximum patients in our study group had variable decelerations,followed by decreased variability(<5bpm) and absent induced acceleration on fetal stimulation. Late decelerations and fetal bradycardia were observed to have most significant correlation with fetal acidosis. Conclusions: From the analysis of this study, it can be concluded that an abnormal CTG should be managed appropriately, without delay, in order to prevent acidosis in the neonate. The obstetrician should be more vigilant in cases of Cat II CTG tracings with bradycardia and late decelerations and monitor such labours closely.