Labor management and neonatal outcomes in cardiotocography categories II and III (Review)

Tsikouras,Panagiotis; Oikonomou,Efthimios; Bothou,Anastasia; Kyriakou,Dimimitrios; Nalbanti,Theopi; Andreou,Sotirios; Daniilidis,Angelos; Peitsidis,Panagiotis; Nikolettos,Konstantinos; Iatrakis,Georgios; Nikolettos,Nikolaos

doi:10.3892/mi.2024.151

Labor management and neonatal outcomes in cardiotocography categories II and III (Review)

Authors:
- Panagiotis Tsikouras
- Efthimios Oikonomou
- Anastasia Bothou
- Dimimitrios Kyriakou
- Theopi Nalbanti
- Sotirios Andreou
- Angelos Daniilidis
- Panagiotis Peitsidis
- Konstantinos Nikolettos
- Georgios Iatrakis
- Nikolaos Nikolettos
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Affiliations: Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece, Midwifery Department of Neonatology, University Hospital Alexandra, 11528 Athens, Greece, 1st Department of Obstetrics and Gynecology, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece, Department of Obstetrics and Gynecology, Helena Venizelou Maternity Hospital, 11521 Athens, Greece, Midwifery Department, University of West Attica, 12243 Athens, Greece
Published online on: April 1, 2024 https://doi.org/10.3892/mi.2024.151
Article Number: 27
Copyright : © Tsikouras et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

The safe care of both mothers and fetuses during labor is a primary goal of all health professionals. The assessment of fetal oxygenation and well‑being is a key aspect of perinatal care provided. Fetal heart rate (FHR) auscultation became part of daily obstetric practice in a number of countries during the 20th century and remains a key method of fetal monitoring, particularly in low‑risk pregnancies. Cardiotocography (CTG) is the continuous monitoring and recording of the FHR and uterine myometrial activity, making it possible to assess the fetal condition. It therefore plays a critical role in the detection of fetal hypoxia during labor, a condition directly related to short‑ and long‑term complications in the newborn. Herein, particular reference is made to the management of CTG category II and III standards, as well as to the handling of childbirth. In addition, specific FHR patterns are associated with immediate neonatal outcomes based on updated studies conducted worldwide. Finally, the prognostic significance of CTG and its potential as a prospective avenue for further investigation are also highlighted herein. Given that the misinterpretation of CTG findings is the most common cause of medical‑legal responsibility, this knowledge field requires more emphasis and attention. The aim of the present review was to further deepen the knowledge on issues that mainly concern the safety and monitoring of pregnant women and fetuses during childbirth.

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