Can CTG (cardiotocography) predict chorioamnionitis and funisitis – a retrospective observational study
Sukumaran, Suganya Pereira, Vanita Mallur, Srinivas Chandraharan, Edwin
Sukumaran, Suganya
Pereira, Vanita
Mallur, Srinivas
Chandraharan, Edwin
Abstract
Objective To analyse the fetal heart rate patterns and changes in uterine contractions on CTG where the histological examination of the placenta confirmed chorioamnionitis and funisitis.
Design The data from the histology of the placenta confirming acute chorioamnionitis and funisitis was collected and correlated with the CTG. Two independent reviewers reviewed the CTG to avoid bias in interpretation. The data was collected from 2014 to 2020.
Methods A retrospective analysis of confirmed chorioamnionitis and or funisitis on histological examination of the placentae and associated features on the CTG traces. The preterm CTGs were excluded in this observational study.
Results 60 cases were identified were the histological examination of the placenta confirmed chorioamnionitis and funisitis over a period of 6 years. Out of the 57 cases, 27 cases (47.4%) had features of funisitis confirmed on histology. 100% of the CTG traces had an increase in the baseline compared to the gestational age with an average of an increase by 25 bpm and variable decelerations with overshoot were noted in cases where funisitis was confirmed in 25 cases (92.6%). Loss of cycling was noted in 54 CTGs and a sinusoidal pattern was identified in 27 CTGs. 42 women (73.7%) had intrapartum pyrexia and none of the mothers had an increased temperature at the point of fetal tachycardia (persistent increase in baseline heart rate by >10 bpm). 25 out of 57 (43.8%) babies did not have a baseline heart rate increase more than 160 bpm. 43 out of 57 CTGs were found to have a uterine tachysystole or hyperstimulation. Uterine hypertonus was noted in 7 out of 57 cases. Only 15 out of 57 (26.3%) cases had meconium stained amniotic fluid (MSAF). 54 (94.7%) out of 57 women had a caesarean mode of delivery and their babies were admitted to special care baby unit (SCBU) after delivery out of which 15 babies were admitted to with APGAR score of 6 or less. There was one neonatal death at 12 h of age because of sepsis.
Conclusion Rising baseline during labour along with loss of cycling with or without features of tachysystole or hyperstimulation in labour should be considered as features of chorioamnionitis. Delivery should be expedited in such cases to avoid adverse perinatal outcomes such as neonatal sepsis, neonatal death and maternal infection. Neonatal sepsis can lead to serious consequences such as cerebral palsy and death.
MIDER Authors
Citations
Altmetric:
Date
2021-06-06
Type
Conference Output
Subject
Obstetrics. Midwifery
Collections
Citation
Sukumaran S, Pereira V, Mallur S, Chandraharan E. Can CTG (cardiotocography) predict chorioamnionitis and funisitis-a retrospective observational study. BJOG. 2021 Jun 6;128(S2):117-129
Journal / Source Title
BJOG: An International Journal of Obstetrics and Gynaecology
DOI
10.1111/1471-0528.9_16715
PMID
Publisher
Wiley