Unstressed Antepartum Cardiotocography in the Management of the Fetus Suspected of Growth Retardation

A detailed analysis of the antenatal cardiotocographs (CTGs) in 57 patients with suspected fetal growth retardation is presented. Four traces were normal and 53 were 'non-reactive'. 'Non-reactive' traces can be sub-divided into three categories, which, in order of severity are, 'suspect', 'flat' and 'ominous'. When compared with the 'suspect' group, perinatal mortality was significantly increased and the Apgar scores at one and five minutes significantly decreased in the 'flat' and 'ominous' groups. The presence of fetal distress in labour was significantly higher in the 'flat' group as compared with the 'suspect' group. Intrauterine deaths occurred only in the 'ominous' group. With experience, ten patients later in the series with 'ominous' patterns were delivered within 24 hours of the detection of such and nine infants survived. At follow-up between 6 and 34 months after birth, psychomotor development was normal in 47 of the 49 surviving infants.