Nonstressed antepartum cardiotocography in patients undergoing elective cesarean section--fetal outcome.

In a prospective study of 409 patients monitored with nonstressed antepartum cardiotocography and delivered by elective cesarean section, cardiotocography was requested for 170 because of clinical indications. This group had higher incidences of abnormal cardiotocography (p less than 0.001), fetal growth retardation (p less than 0.001) and neonatal deaths (p less than 0.025) than had the group without such requests, suggesting that clinicians effectively selected the high-risk pregnancy for testing of fetal well-being. Cardiotocographic evidence of critical reserve was found in 17 of 170 patients (10%) tested for a clinical indication and in none of the 239 patients in the control group. Patients with abnormal cardiotocography results had significantly higher incidences of cord arterial blood pH less than 7.26 (p less than 0.05) and Apgar scores of less than 6 at 1 minute (p less than 0.001), showing that an abnormal cardiotocogram is indicative of a fetus at risk of having hypoxia.