Association of Pathological Cardiotocograph with Adverse Fetal Outcomes

Background: Cardiotocography (CTG) is a standard, non-invasive mode of intrapartum monitoring of the fetus. Pathological CTG patterns are consistently correlated with perinatal morbidity/mortality and fetal distress. While the clinical significance of CTG has been validated, local studies examining the association are not common, particularly in resource-poor areas. Objective: To compare the frequency of adverse fetal outcomes in pathological and normal cardiotocograph. Study Design: Descriptive cross-sectional study. Duration and Place of Study. This study was conducted from July to December 2024 at the Department of Obstetrics and Gynaecology, POF Hospital, Wah Cantt. Methodology: A total of 378 women in labor with singleton pregnancies beyond 36 weeks were enrolled. CTG findings were categorized as normal or pathological based on predefined criteria. Adverse fetal outcomes assessed included 5-minute Apgar score <5, neonatal resuscitation, and early neonatal death (within 48 hours). Results: Pathological CTG was observed in 37 women (9.8%). Among them, 15 (40.5%) neonates had low Apgar scores, 11 (29.7%) required resuscitation, and 14 (37.8%) experienced early neonatal death. In contrast, among 341 women (90.2%) with normal CTG, the rates were significantly lower: low Apgar in 47 (13.8%), resuscitation in 35 (10.3%), and early neonatal death in 4 (1.2%) (p < 0.001). Conclusion: Pathological cardiotocography is strongly associated with adverse fetal outcomes and should be considered a critical component of intrapartum monitoring, especially for high-risk pregnancies.