Comparative study between intermittent auscultation and cardiotocogram in low risk group during labour in Libya

The goal of fetal heart rate monitoring has been early identification of the fetus at risk for hypoxic insult. The aim of this study is to establish the relation between FHR monitoring (CTG, intermittent auscultation) and fetal outcome and mode of delivery. It is prospective observational comparative study carried out in Zawia hospital maternity word. Study population consists of 200 women in labor having the criteria of low risk group included singleton pregnancies between 37 - 40 weeks gestation, half of them monitored by intermittent auscultation and the other half by CTG. In this study, 200 women, 100 of them fetal monitoring was done by continuous electronic monitoring by CTG, the other monitored by intermittent auscultation by pinard stethoscope. Caesarean sections were performed for 31% and 6% of both groups (electronic monitoring and pinard stethoscope) respectively, statistically significant. There are three cases delivered by instrumental delivery (ventose) one in CTG and two in fetoscpo group. Abnormality in fetal heart rate was detected in (12%) of electronic monitoring group (3.5%) of the pinard stethoscope group. The apgar score of babies in both group nearly the same (p = 0.411). The babies whose transferred in intensive care unit is higher in CTG group (26 - 20%, 9 - 6%, p = 0.374). One in CTG group has neonatal seizure. It is concluded that abnormalities in fetal heart rate were more reliably detected by electronic monitoring than with pinard stethoscope. Uses of continuous electronic monitoring carry high rate of cesarean section with no significant difference in neonatal outcome.