The New Indian Journal of OBGYN. Epub Ahead of Print

A cross-sectional study on role of labor admission test by CTG as a predictor of perinatal outcome

Mayuri Hiwale, Kiran Rajole, Kunal Aher

ABSTRACT

Background: Perinatal hypoxia is a major contributor to neonatal mortality and morbidity worldwide. Intrapartum assessment of fetal well-being has become an integral part of labour management. Labor admission test (LAT), a test of fetal well-being, can be utilized as a screening tool in early labor to detect compromised fetuses on admission. Objectives: This study was undertaken to evaluate the efficacy of LAT in assessing fetal well-being at the onset of labor and comparing the test results with neonatal outcomes. Material and methods: This was a cross-sectional study conducted among women admitted in labor room of a tertiary care teaching hospital. LAT was performed following which, the patients were classified according to FHR tracings obtained as ‘Reactive’, ‘Equivocal’ and ‘Non-reactive. Perinatal outcomes of these patients were also assessed. Results: Out of 165 patients that participated in the study, 106 (64.2%) had reactive, 6 (3.6%) had equivocal and 53 (32.1%) had non-reactive FHR trace on LAT. Out of the patients with a non-reactive trace, 8 (15.1%) had an APGAR score at 5 minutes of less than 7, 8 (15.1%) patients had meconium stained liquor and 45 (84.9%) were delivered through LSCS. About 27 (50.9%) newborns required admission into the NICU in this group. Conclusions: LAT can be used as a simple, non-invasive, inexpensive screening tool to identify fetuses who are unlikely to cope with the stress of labor and become hypoxic especially when continuous electronic fetal monitoring is not possible for every patient due to economic constraints.