PREDICTIVE ACCURACY OF ADMISSION CARDIOTOCOGRAPHY IN SCREENING FOR FETAL ACIDOSIS USING UMBILICAL CORD PH AMONGST PARTURIENTS IN ABUJA, NIGERIA.

Dr. Mahmoud A.R.*, Dr. Agboghoroma C.O., Dr. Efetie E.R., Dr. Durojaiye K.W., Dr. Audu L.I.

ABSTRACT

BACKGROUND: Assessment of fetal wellbeing during labour may be achieved through cardiotocography (CTG) on admission. It is a screening test that can detect fetuses with existing compromise or predict fetal wellbeing in labour. It allows for timely intervention to reduce possible neurological damage and perinatal death. The linkages between this screening and perinatal outcome is being explored in this study. OBJECTIVE: To evaluate the accuracy of cardiotocography in predicting neonatal asphyxia and to analyze cardiotocographic findings of parturients on admission with neonatal outcome. METHODS: This was a cross-sectional study of parturients in the labour ward of National Hospital Abuja between October 2018 to March 2019. A 20 minutes admission cardiotocography was done in parturient who fulfilled the inclusion criteria and classified according to National Institute for Health and Care Excellence (NICE)-Clinical guideline 2017. Umbilical cord arterial blood pH status and Apgar score were documented. The data was analyzed with the aid of Statistical Package for Social Sciences (SPSS) version 22. Test of association for categorical variables were done using the chi-square test, P value <0.05 was regarded as statistically significant. Predictive accuracy of admission carditocography was determined using sensitivity, specificity and tests for predictive value. RESULTS: Out of 170 parturients, 147(86.5%) recorded a normal tracing, 20(11.8%) had suspicious tracing, while a pathological tracing was recorded in 3(1.8%). Using pH <7.2 as a criteria for diagnosing acidosis, admission cardiotocography as a screening test had a sensitivity of 73.3%, specificity of 97.3%, positive predictive value of 47.8%, negative predictive value of 92.3% and a predictive accuracy of 90.6%. CONCLUSION: Admission cardiotocography helps in identifying early fetal compromise, so that early intervention can be made thereby reducing fetal mortality and morbidity.

Keywords: Admission CTG, mode of delivery, ph status, Apgar score, diagnostic accuracy.