Study of Immediate Post-Partum Umbilical Cord Blood Gas Analysis in Relation to Foetal Heart Rate Patterns (NST/CTG) in High-Risk Pregnancies

Abstract

Introduction: CTG plays an important role in the identification of foetal hypoxia but also has high false-positive rates and is a poor predictor of foetal acidosis. Umbilical artery pH identifies newborns at risk of hypoxia and predicts neonatal outcomes. Hence, this study was conducted to study the correlation between Immediate post-partum umbilical cord gas analysis and Foetal heart rate patterns (NST/CTG) in High-risk pregnancies.

Objectives: Primary Objective: 1. Study of immediate post-partum umbilical cord arterial blood gas analysis in relation to foetal heart pattern (CTG/NST) in High-risk pregnancies.

Secondary Objective:

To assess foetal well-being by using NST/CTG in high-risk pregnancies in antenatal period.

To assess neonatal well-being by using Cord blood ABG in high-risk pregnancies.

Methods: Prospective Observational study. High-risk pregnant females fulfilling the inclusion criteria were enrolled in the study and NST/CTG was obtained before delivery. Immediately after birth blood sample from Umbilical cord artery was obtained and sent for ABG analysis and their correlation was studied.

Results: Out of 80 High-risk pregnant females, thirty-seven (46.25%) females had Reassuring CTG of which   one (2.7%) baby had acidosis at birth and forty-three (53.75%) had Non-reassuring CTG, of which twenty-one (48.8%) babies had acidosis at birth. Thirty (69.76%) babies with non-reassuring CTG were admitted to the NICU and five (13.51%) babies with reassuring CTG were admitted to the NICU. A significant correlation (p-value <0.001) was found between CTG, Acidosis at birth, NICU admissions, and CTG.

Conclusions: Significant associations were found between non-reassuring CTG and pH, lactate values, and NICU admissions. No significant association was found between pH, Lactate, and non-reassuring CTG with perinatal outcomes for babies admitted to NICU.