Key result
High-risk pregnancies were associated with a higher rate of suspicious antepartum cardiotocogram patterns compared to normal pregnancies (17.4% vs 7.2%), as well as higher recurrence rates.
Why the study?
What is the clinical significance and recurrence rate of suspicious antepartum cardiotocograms in normal versus high-risk pregnancies?
Observational (n=496)
What is the clinical significance and recurrence rate of suspicious antepartum cardiotocograms in normal versus high-risk pregnancies?
A single suspicious antepartum CTG has limited predictive value and does not justify intervention, but adequate follow-up of repeat suspicious CTGs can help identify pregnancies requiring intervention.
Single suspicious CTGs should not prompt intervention; leaves open whether serial monitoring improves outcomes in high-risk pregnancies.
Analysis of 594 antepartum cardiotocograms (CTGs) from 91 strictly normal pregnancies and of 2770 CTGs from 405 high-risk pregnancies showed a suspicious pattern in 7.2 and 17.4 per cent respectively. Careful analysis of these CTGs shows that they cannot be considered as either normal or abnormal, whereas their value for predicting the outcome of pregnancy is too limited to be of a direct clinical significance. Although their characteristics vary little between normal and high-risk pregnancy, their recurrence rate is much higher in high-risk pregnancy. During high-risk pregnancy this pattern was obtained on at least two consecutive recordings in 13.3 per cent and on at least three consecutive recordings in 6.2 per cent of patients, as compared to respectively 3.3 and 1.1 per cent during normal pregnancy. Although a single or even repeat occurrence of a suspicious CTG does not justify intervention during pregnancy, our study shows that an adequate follow-up of repeat CTGs will usually be able to distinguish pregnancies that are in need of intervention from those that are not.
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Keirse et al. (1981) conducted an observational in Pregnancy (n=496). High-risk pregnancy vs. Normal pregnancy was evaluated on Suspicious pattern on antepartum cardiotocogram. High-risk pregnancies were associated with a higher rate of suspicious antepartum cardiotocogram patterns compared to normal pregnancies (17.4% vs 7.2%), as well as higher recurrence rates.
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