Prediction of labour outcomes using prelabour computerised
cardiotocogram and maternal-foetal Doppler indices: A prospective cohort
Objectives: To investigate the association and the potential
value of prelabour fetal heart rate short-term variability (STV)
determined by computerised cardiotocography (cCTG) and maternal-foetal
Dopplers in predicting labour outcomes. Design: Prospective
cohort study. Setting: The Prince of Wales Hospital, a tertiary
maternity unit, in Hong Kong SAR. Population: Women with a term
singleton pregnancy in latent phase of labour or prior to labour
induction were recruited during May 2019 – November 2021.
Methods: Ultrasonographic assessment of foetal growth, Doppler
velocimetry and the cCTG monitoring including Dawes-Redman CTG analysis.
Main Outcome Measures: Umbilical Cord arterial pH, emergency
delivery due to pathological CTG during labour and neonatal intensive
care unit (NICU)/special care baby unit (SCBU) admission.
Results: Of the 400 cases, 34 (8.5%) women underwent emergency
delivery for pathological CTG during labour. A total of 6 (1.50%) and
148 (37.00%) newborns required NICU and SCBU admission, respectively.
Middle cerebral artery pulsatility index (MCA-PI) and MCA-PI z-score
were significant lower in pregnancies that required emergency delivery
for pathological CTG during labour compared with those who did not
[1.23 (1.07-1.40) vs 1.40 (1.22-1.64), p=0.002 and 0.55 (±1.07) vs
0.12 (±1.06), p=0.049,]. Umbilical cord arterial pH was associated
with STV (r = 0.107, p = 0.035) and the independent predictors for
umbilical cord arterial pH were smoking (p = 0.006) and STV (p = 0.025).
Conclusions: In pregnant women admitted in latent phase of
labour or for induction of labour at term, cCTG STV is associated with
umbilical cord arterial pH but not predictive of emergency delivery due
to pathological CTG during labour.