Neonatal Outcomes in Intrapartum Pathological CTG in Low-risk Pregnancies

Objective: The study aimed to investigate the neonatal outcomes of intrapartum pathological CTG patterns in low-risk women during labor. Methodology: This retrospective cohort study included 120 low-risk pregnant women who experienced pathological CTG patterns during labor. This study was conducted over a period of 12 months, from May 2023 to April 2024, in PAF hospital, Islamabad. Low-risk women were defined as those without pre-existing medical conditions or obstetric complications. Pathological CTG patterns were identified and categorized based NICE guideline [NG229]. Data on neonatal outcomes, including Apgar scores, neonatal resuscitation, admission to NICU, and perinatal mortality, were collected from medical records. Statistical analysis was performed to determine the association between pathological CTG patterns and neonatal outcomes. Results: The study was comprised of 120 low-risk females having the mean age of 28.4 ± 4.2 years. Pathological CTG patterns were classified into three categories: bradycardia, tachycardia, and variable decelerations. Among the study cohort, 45% (n=54) exhibited bradycardia, 30% (n=36) exhibited tachycardia, and 25% (n=30) exhibited variable decelerations. Neonatal outcomes revealed that 20% (n=24) of neonates had an Apgar score of <7 at 1 minute, while 10% (n=12) had an Apgar score of <7 at 5 minutes. Neonatal resuscitation was required in 15% (n=18) of cases. Statistical analysis showed that bradycardia was significantly related with low Apgar scores at 1 minute (p=0.03) and 5 minutes (p=0.04). Tachycardia was significantly associated with the need for neonatal resuscitation (p=0.02) and NICU admission (p=0.01). Conclusion: Intrapartum pathological CTG patterns in low-risk women were found to be associated with low Apgar scores, the need for neonatal resuscitation, and NICU admission. Bradycardia and tachycardia, in particular, were significant predictors of these adverse outcomes.