Role of admission cardiotocography in predicting the fetomaternal outcome: A prospective observational study

Introduction: Admission cardiotocography (CTG) is a non-invasive screening tool used at the time of labor to assess fetal well-being, especially in high-risk pregnancies. This study evaluates its effectiveness in predicting fetomaternal outcomes. Materials and Methods: This prospective observational study was conducted at a tertiary care hospital over six months. Eighty term antenatal women in labor were categorized into low- and high-risk groups. A 20-minute admission CTG was performed upon arrival. Tracings were interpreted per NICE guidelines. Associations between CTG patterns and maternal risk status, delivery mode, Apgar scores, NICU admissions, and need for neonatal resuscitation were statistically analyzed using Chi-square tests. Results: Reassuring CTG was significantly more common in low-risk pregnancies (91.1%), while all pathological traces were found in high-risk cases (p = 0.01). Abnormal CTG patterns were strongly associated with cesarean delivery and adverse neonatal outcomes, including low Apgar scores and NICU admissions. Sensitivity and NPV for predicting low Apgar scores at 1 minute were high across both groups (87.5–88.75%). Conclusion: Admission CTG is a practical and effective screening tool for identifying fetuses at risk during labor. Its high specificity and negative predictive value support its use, particularly in high-risk pregnancies.