COMPARISON OF INTRAPARTUM CARDIOTOCOGRAPHY & OBSTETRIC DOPPLER IN PREDICTING PERINATAL OUTCOME IN HIGH RISK PREGNANCY

Abstract

Background: High risk pregnancy needs special antepartum as well as intrapartum care and investigations. CTG is aadmissionscreening test to monitor fetal wellbeing by use of cardiotocograph. It monitors fetal heart rate and uterine contractions. Color Doppler is ultrasound dependent test which uses vascular flow velocities and Doppler waveform to predict fetal outcome. Objective: Comparison of efficiency of CTG & Color Doppler ultrasound for intrapartum fetal surveillance in high risk pregnancy. Methods: Retrospective study of 100 high risk pregnancies of ≥ 34 weeks POG in labor with CTG and color Doppler findings were done on admission at Gujarat Adani Institute of Medical Sciences, Bhuj. Subjects were classified into 4 groups based on CTG and color Doppler findings. Maternal and fetal outcome were recorded and correlated with CTGand color Dopplerfindings. Results: Most common cause of high-risk pregnancy was preeclampsia(n=60/100,60%).In our study, rate of normal delivery was 40% and c-section was 60% (31% elective & 29% emergency). Out of 100 fetuses, 76 were healthy, 22 were admitted in NICU (6 NICU deaths) and 2 were still birth. Perinatal outcome was most favorable with normal CTG and Color doppler and was least favorable with both of them abnormal. Outcome was intermittent in other two groups. CTG found to have sensitivity 62.5% and specificity 82.5% in detection of adverse fetal outcome. Similarly,sensitivity and specificity of color doppler was 48.8% and 98.6% respectively. Conclusions: In our study it was found that CTG is more sensitive and color Doppler is more specific in detection of adverse fetal outcome.