Role of fetal monitoring in high risk pregnancy by fetal electrocardiogram

Background: Non-stress test is an external monitoring of fetal heart rate by electrocardiograph. Although intermittent auscultation of fetal heart rate is equivalent to continuous electronic fetal monitoring in detecting fetal compromise1 but continuous electronic fetal monitoring is indicated in high risk patients women whose foetuses are at high risk for neonatal encephalopathy or cerebral palsy.2 Objective         of current study was to study the efficacy and diagnostic value of non-stress Test for surveillance and its usefulness to detect fetal distress at early stage which help to decide further management in mode of delivery.Methods: Design: prospective study. NST was done in 50 high risk patients for minimum of 20 minutes and in patients with non-reactive non stress test it was continued for 40 minutes. Maternal age, parity, complications during labour, and delivery, mode of delivery, indications of caesarean section and perinatal outcome were noted. Results: Out of total 50 cases studied patient delivered vaginally were 24 and Caesarean was done in 26 cases. Most LSCS were performed due to PIH (35%) and related complications like IUGR, eclampsia (10%), fetal distress, previous caesarean pregnancy, IUGR, oligohydraminos and meconium stained liquor. 52% patients were delivered by caesarean and 48% by normal delivery.Conclusions: Routine use of electronic fetal heart monitoring helped in reduction of neonatal morbidity and mortality with increased rate of caesarean section