LAUSR

Electronic fetal monitoring using cardiotocograph(CTG) is used to monitor fetal well-being. Babies born with setting of category II CTG may or may not have fetal acidemia. The usual practice is to do umbilical arterial blood gas (ABG) for all babies who are depressed at birth. However, there is no clarity about utility of umbilical arterial blood gas in babies born after category II CTG. Aim This study was done to find utility of performing ABG in vigorous babies with category 2 CTG and to correlate neonatal outcomes (moderate to severe encephalopathy and neonatal death) with cord pH and base deficit in vigorous and non-vigorous neonates. Material & Methods Design Prospective Cohort Study Methodology We did umbilical arterial cord pH and base deficit for 490 consecutive neonates with category II CTG according to NICHD 2008 classification. Cord pH >7 and base deficit ≥−12.0 was considered normal. Newborn babies were monitored for following outcomes – moderate to severe encephalopathy, need of inotropes and death. Results Eighty six(86) of 490 neonates were non-vigorous and 404 were vigorous at birth. All 404 vigorous babies had cord pH >7 and none of them died or had encephalopathy. Out of 86 non-vigorous neonates, 3 had cord pH <7 and another 6 had base deficit <-12. Two out of 86 babies had moderate to severe encephalopathy and one of them died. Conclusion Umbilical arterial blood analysis did not have added advantage over APGAR score in detection of encephalopathy or death in category II CTG.