J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website https://www.jcgo.org

Original Article

Volume 11, Number 1, March 2022, pages 9-13

Is the Admission Cardiotocography Test Predictive of an Emergent Cesarean Delivery During Labor in Prolonged Pregnancies?

**Table 1.** Characteristics of the Cohort: Comparison Between “Normal” and “Indeterminate” FHR During the Admission Cardiotocography Test in Prolonged Pregnancies
	Entire cohort (N = 335)	Normal FHR (category 1)^a (N = 260)	Indeterminate FHR (category 2)^a (N = 75)	P-value^b
^aAccording to the American College of Obstetrics and Gynecology classification. ^bComparison between “normal” and “indeterminate” FHR during admission cardiotocography test. FHR: fetal heart rate.
Maternal age (years)	30 (16 - 46)	30 (16 - 46)	29 (20 - 45)	0.14
Body mass index (kg/cm²)	28 (18 - 46)	28 (18 - 46)	28 (19 - 44)	1
Parity	1 (0 - 6)	1 (0 - 6)	0 (0 - 4)	0.31
History of scarred uterus (%)	33 (9.9)	24 (9.2)	9 (12)	0.48
Gestational age at delivery (weeks)	41.2 (41.0 - 41.9)	41.2 (41.0 - 41.9)	41.2 (41.0 - 41.7)	0.18
Labor induction (%)	157 (46.9)	120 (46.2)	37 (49.3)	0.63
Spontaneous rupture of the membranes before onset of labor (%)	58 (17.3)	43 (16.5)	15 (20)	0.48
Oligoamnios (%)	10 (3.0)	6 (2.3)	4 (5.3)	0.17
Baby weight (g)	3,510 (2,060 - 4,640)	3,510 (2,060 - 4,640)	3,500 (2,500 - 4,300)	0.44

Table 1. Characteristics of the Cohort: Comparison Between “Normal” and “Indeterminate” FHR During the Admission Cardiotocography Test in Prolonged Pregnancies

Entire cohort (N = 335)

Normal FHR (category 1)^a (N = 260)

Indeterminate FHR (category 2)^a (N = 75)

P-value^b

^aAccording to the American College of Obstetrics and Gynecology classification. ^bComparison between “normal” and “indeterminate” FHR during admission cardiotocography test. FHR: fetal heart rate.

Maternal age (years)

30 (16 - 46)

29 (20 - 45)

0.14

Body mass index (kg/cm²)

28 (18 - 46)

28 (19 - 44)

Parity

1 (0 - 6)

0 (0 - 4)

0.31

History of scarred uterus (%)

33 (9.9)

24 (9.2)

9 (12)

0.48

Gestational age at delivery (weeks)

41.2 (41.0 - 41.9)

41.2 (41.0 - 41.7)

0.18

Labor induction (%)

157 (46.9)

120 (46.2)

37 (49.3)

0.63

Spontaneous rupture of the membranes before onset of labor (%)

58 (17.3)

43 (16.5)

15 (20)

0.48

Oligoamnios (%)

10 (3.0)

6 (2.3)

4 (5.3)

0.17

Baby weight (g)

3,510 (2,060 - 4,640)

3,500 (2,500 - 4,300)

0.44

**Table 2.** Perinatal Outcomes: Comparison Between “Normal” and “Indeterminate” FHR During the Admission Cardiotocography Test in Prolonged Pregnancies
	Entire cohort (N = 335)	Normal FHR (category 1)^a (N = 260)	Indeterminate FHR (category 2)^a (N = 75)	P-value^b
^aAccording to the American College of Obstetrics and Gynecology classification. ^bComparison between “normal category 1” and “indeterminate category 2” FHR during the admission cardiotocography test. FHR: fetal heart rate.
Cesarean delivery (%)	65 (19.4)	38 (14.6)	27 (36)	< 0.01
Cesarean delivery for fetal distress (%)	46/65 (76.7)	22/38 (57.9)	24/27 (88.9)	0.02
Operative vaginal delivery (%)	74 (22.1)	55 (21.1)	19 (25.3)	0.44
Neonatal pH	7.23 (6.99 - 7.42)	7.23 (7.02 - 7.42)	7.23 (6.99 - 7.41)	0.95
Neonatal lactates (mmol/L)	4.5 (1.5 - 12)	4.25 (1.5 - 12)	4.25 (2.0 - 9.0)	0.82
Apgar score (5 minutes)	10 (1 - 10)	10 (4 - 10)	10 (1 - 10)	0.21
Apgar score (5 min) < 7 (%)	4 (1.2)	2 (0.7)	2 (2.7)	0.17
Hospitalization in neonatal intensive care unit (%)	3 (0.9)	2 (0.8)	1 (1.3)	0.53

Table 2. Perinatal Outcomes: Comparison Between “Normal” and “Indeterminate” FHR During the Admission Cardiotocography Test in Prolonged Pregnancies

Entire cohort (N = 335)

Normal FHR (category 1)^a (N = 260)

Indeterminate FHR (category 2)^a (N = 75)

P-value^b

^aAccording to the American College of Obstetrics and Gynecology classification. ^bComparison between “normal category 1” and “indeterminate category 2” FHR during the admission cardiotocography test. FHR: fetal heart rate.

Cesarean delivery (%)

65 (19.4)

38 (14.6)

27 (36)

< 0.01

Cesarean delivery for fetal distress (%)

46/65 (76.7)

22/38 (57.9)

24/27 (88.9)

0.02

Operative vaginal delivery (%)

74 (22.1)

55 (21.1)

19 (25.3)

0.44

Neonatal pH

7.23 (6.99 - 7.42)

7.23 (7.02 - 7.42)

7.23 (6.99 - 7.41)

0.95

Neonatal lactates (mmol/L)

4.5 (1.5 - 12)

4.25 (1.5 - 12)

4.25 (2.0 - 9.0)

0.82

Apgar score (5 minutes)

10 (1 - 10)

10 (4 - 10)

10 (1 - 10)

0.21

Apgar score (5 min) < 7 (%)

4 (1.2)

2 (0.7)

2 (2.7)

0.17

Hospitalization in neonatal intensive care unit (%)

3 (0.9)

2 (0.8)

1 (1.3)

0.53

**Table 3.** Predictors for Emergency Cesarean During Labor in Case With the Observation of a Category 2 Fetal Heat Pattern During the Admission Test in Prologned Pregnancy
	Odds ratio	95% confidence interval	P-value
^aAccording to the American College of Obstetrics and Gynecology classification. FHR: fetal heart rate.
Parity	0.46	0.3 - 0.7	< 0.01
Gestational age at delivery	2.35	0.6 - 8.8	0.20
Labor induction	1.68	0.9 - 3.1	0.09
Scarred uterus	9.08	3.6 - 23.2	< 0.01
Category 2 FHR pattern^a	3.47	1.8 - 6.5	< 0.01

Table 3. Predictors for Emergency Cesarean During Labor in Case With the Observation of a Category 2 Fetal Heat Pattern During the Admission Test in Prologned Pregnancy

Odds ratio

95% confidence interval

P-value

^aAccording to the American College of Obstetrics and Gynecology classification. FHR: fetal heart rate.

Parity

0.46

0.3 - 0.7

< 0.01

Gestational age at delivery

2.35

0.6 - 8.8

0.20

Labor induction

1.68

0.9 - 3.1

0.09

Scarred uterus

9.08

3.6 - 23.2

< 0.01

Category 2 FHR pattern^a

3.47

1.8 - 6.5

< 0.01