Abstract:
Objectives: This study evaluates the relationship between Cardiotocography (CTG) variations and delivery outcomes in
women undergoing a Trial of Labor After Cesarean (TOLAC). CTG variations, such as abnormal fetal heart rate (FHR)
patterns, can indicate fetal distress or complications during labor. The study focuses on predicting outcomes such as vaginal
birth success, caesarean section, and complications like uterine rupture and scar dehiscence.
Study Design and Setting: A case-control study was conducted at Lady Reading Hospital, Peshawar, from August 2022
to February 2023. The study involved 156 women, divided into two groups: 78 with unsuccessful vaginal deliveries (cases)
and 78 with successful vaginal deliveries (controls).
Methodology: CTG was used to assess FHR patterns during labor, focusing on tachycardia, bradycardia, variability, and
deceleration patterns. The study analyzed the later stages of labor and the impact of maternal factors such as age, BMI,
and gestational age.
Results: Abnormal CTG readings, including fetal tachycardia (odds ratio 3.1) and bradycardia (odds ratio 2.2), were
associated with poorer delivery outcomes. Maternal factors like age, BMI, and gestational age also influenced complications
during labor.
Conclusions: CTG is an effective tool in managing TOLAC, improving maternal and neonatal outcomes. Its integration
into labor protocols can reduce risks, particularly in low- and middle-income countries. Further research is needed to address
maternal complications.
