Retrospective analysis of the effect of electronic cardiotocography on selected birth and neonatal variables among 4172 women from a Single Centre in Warsaw, Poland.

Abstract

Objectives: Cardiotocography (CTG) is widely used for continuous or intermittent assessment of fetal heart function. This study aimed to compare the effects of continuous and intermittent CTG during labour on selected variables.

Material and methods: In a retrospective study, 4172 medical records of Warsaw Hospital (Poland) patients were analysed. The study group consisted of 2111 women with continuous CTG during labour and the control group of 2061 women with intermittent CTG.

Results: In the group with intermittent CTG, a higher odds ratio of caesarean section (OR = 1.06, 95% CI = 0.87-1.30), second-degree perineal tear (OR = 1.65, 95% CI = 1.07-2.55),third- and fourth-degree perineal tears (OR = 5.13, 95% CI = 1.12-23.53) and oxygen therapy (OR = 1.76, 95% CI = 1.19-2.59) were noted. In the group with intermittent CTG, a lower odds ratio of a newborn with an Apgar score of ≤ 7 points in the fifth minute of life (OR = 0.34, 95% CI = 0.12-0.94), nCPAP (Nasal Continuous Positive Airway Pressure) (OR = 0.56, 95% CI = 0.36-0.86) and resuscitation (OR = 0.37, 95% CI = 0.17-0.79)) were observed. The analysis shows that in the group of women with intermittent CTG during labour, the odds ratio of abnormal BE result was lower (OR=0.45, 95% CI = 0.21-0.98).

Conclusions: Continuous CTG during labour in high-risk women increases the likelihood of instrumental delivery (using vacuum) and perineal incision compared with intermittent CTG. The use of intermittent CTG during labour reduces the number of newborns with Apgar scores ≤ 7 points and decreases the number of neonatal interventions such as nCPAP and resuscitation.