Admission test as a screening test for fetal distress in labour

Background: This study was undertaken with the purpose of evaluating the efficacy of labour admission test as a screening test to identify the compromised fetus or fetus at risk and to correlate with perinatal outcome.Methods: This was a retrospective cohort study of 300 patients in 1st stage of labour admitted to labour room at tertiary care hospital over a period of one and a half years. Patients with Singleton pregnancy, Cephalic presentation & Gestational age beyond 34 weeks were included in this study. A BPL electronic foetal heart monitor was used to perform the admission test. With the patient in left lateral position a 20 minute continuous electronic recording (paper speed of 3 cm per minute) of foetal heart rate and uterine activity was obtained, on a cardiotocograph.Results: Statistical significance was calculated between different categories for different parameters too. A p value of of<0.05 was considered to be statistically significant. Fetal distress was seen 64.71% in Category III group 33.33% with Category II group and 4.74 % in Category I trace. admission test has 97.75% specificity and 95.5% negative predictive value.Conclusions: Admission test makes screening convenient. Since it is non-invasive, patients also cooperate. Admission test helps to plan subsequent management of labour. It is a good predictor of foetal well-being at the time of admission and for the next few hours

Comparison of progress of labour and maternofetal outcome among induced versus spontaneous labour in nulliparous women using modified WHO partograph

Background: Induced or spontaneous labour has implication on the eventual mode of delivery and neonatal outcome. The aim of study is to compare the progress and outcome of induced versus spontaneous labour among nulliparous women using the modified WHO partograph.Methods: Comparative study involving nulliparous women in active phase of labour with the cervix at least 4cm dilated. Those whose labours were induced were compared with those on spontaneous labour; both labouring women were monitored using modified WHO partograph. Outcome measures include the mean duration of labour, the eventual mode of delivery and the Maternofetal outcome. Data were managed using SPSS software. Chi-square t-test and student t-test were used in data analysis. Level of significance was placed at P<0.05.Results: 115 women were compared in each group. There was no difference in mean age group, gestational age at delivery, cervical dilatation on admission, and the level of head of fifth palpable on admission. More women had spontaneous vaginal delivery among those in spontaneous labour (72.1% versus 64.7%) P=0.0001. There were less caesarean section among those in spontaneous labour. The mean Apgar scores were significantly better among induced labour babies (P=0.0001).Conclusions: Induced labour may increase the chances of caesarean section, it does not adversely affect the neonatal outcome. Therefore, it is advised induced labour can be a safe procedure among nulliparous women if labour is partographically monitored

Comparison of progress of labour and maternofetal outcome among induced versus spontaneous labour in nulliparous women using modified WHO partograph

Background: Induced or spontaneous labour has implication on the eventual mode of delivery and neonatal outcome. The aim of study is to compare the progress and outcome of induced versus spontaneous labour among nulliparous women using the modified WHO partograph.Methods: Comparative study involving nulliparous women in active phase of labour with the cervix at least 4cm dilated. Those whose labours were induced were compared with those on spontaneous labour; both labouring women were monitored using modified WHO partograph. Outcome measures include the mean duration of labour, the eventual mode of delivery and the Maternofetal outcome. Data were managed using SPSS software. Chi-square t-test and student t-test were used in data analysis. Level of significance was placed at P&lt;0.05.Results: 115 women were compared in each group. There was no difference in mean age group, gestational age at delivery, cervical dilatation on admission, and the level of head of fifth palpable on admission. More women had spontaneous vaginal delivery among those in spontaneous labour (72.1% versus 64.7%) P=0.0001. There were less caesarean section among those in spontaneous labour. The mean Apgar scores were significantly better among induced labour babies (P=0.0001).Conclusions: Induced labour may increase the chances of caesarean section, it does not adversely affect the neonatal outcome. Therefore, it is advised induced labour can be a safe procedure among nulliparous women if labour is partographically monitored

Admission test as a screening test for fetal distress in labour

Background: This study was undertaken with the purpose of evaluating the efficacy of labour admission test as a screening test to identify the compromised fetus or fetus at risk and to correlate with perinatal outcome.Methods: This was a retrospective cohort study of 300 patients in 1st stage of labour admitted to labour room at tertiary care hospital over a period of one and a half years. Patients with Singleton pregnancy, Cephalic presentation &amp; Gestational age beyond 34 weeks were included in this study. A BPL electronic foetal heart monitor was used to perform the admission test. With the patient in left lateral position a 20 minute continuous electronic recording (paper speed of 3 cm per minute) of foetal heart rate and uterine activity was obtained, on a cardiotocograph.Results: Statistical significance was calculated between different categories for different parameters too. A p value of of&lt;0.05 was considered to be statistically significant. Fetal distress was seen 64.71% in Category III group 33.33% with Category II group and 4.74 % in Category I trace. admission test has 97.75% specificity and 95.5% negative predictive value.Conclusions: Admission test makes screening convenient. Since it is non-invasive, patients also cooperate. Admission test helps to plan subsequent management of labour. It is a good predictor of foetal well-being at the time of admission and for the next few hours