Association of Cardiotocographic (CTG) Abnormalities with Delivery Outcomes in Women with a History of Cesarean Section

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.