Cardiotocographic Examination Results Of International Federation Of Gynecology And Obstetrics And National Institute Of Child Health And Human Development Classification As A Predictor Of Newborn Outcomes
Akhmad Taufiq, Efendi Lukas, A. Mardiah Tahir, and Firdaus Hamid

Obstetry and Gynecology Department
Medical Faculty of Hasanuddin University
Makassar, Indonesia

Abstract

Background: Cardiotocography (CTG) is an electronic equipment used to identify fetuses at risk of hypoxia and intrauterine death or neurological damage. Various classification systems for interpretation have been developed such as the FIGO classification system in 2015 and NICHD in 2008. Asphyxia is a failure of gas exchange which, if it persists, will cause worsening of hypoxemia and hypercapnia. A fetus that is unable to survive in this condition has the risk of organ damage due to hypoxia with long-term consequences. Several studies have been conducted to compare the accuracy of several classification systems. However, until now there has been no research conducted to determine the suitability of the classification system according to FIGO and NICHD in terms of interpretation of fetal heart rate images and the results of APGAR Score and blood gas analysis obtained from the umbilical cord at the time the baby is born.

Objective: To analyze the suitability of the CTG results based on the FIGO and NICHD classification system on the results of APGAR Score and newborn blood gas analysis.

Methods: This correlative analytic study with a Cross Sectional study was conducted at the Emergency Room (ER) of obstetrics and gynecology department of RSUP Dr. Wahidin Sudirohusodo period April 2019 - April 2020. Samples that fit the criteria amounted to 50 pregnant women at risk of fetal hypoxia by cardiotocography then classified based on FIGO and NICHD. Samples were collected at delivery with the results of APGAR Score and Newborn cord blood gas analysis

Results: From 50 samples, the CTG results were divided according to FIGO (86% suspicious and 14% pathological), and NICHD (86% category 2 and 14% category 3). There was a significant relationship between cardiotocographic features according to FIGO and NICHD to the first (p value 0,001) and fifth minute (p value 0,001) APGAR scores with similar distributions. There was a significant relationship between cardiotocographic features according to FIGO and NICHD to the results of umbilical cord blood gas analysis of newborns with a similar distribution (p value 0.005).

Conclusion: Cardiotocographic features both according to FIGO and NICHD have the same predictive ability to APGAR Score and results of the Newborn cord blood gas analysis.

Keywords: cardiotococgraphy, FIGO, NICHD, APGAR score, blood gas analysis

Topic: Maternal, neonatal, and child health