Ginekologia polska · 2026
Cardiotocography patterns are stronger predictors of neonatal acidemia than decision-to-delivery interval in emergency cesarean deliveries.
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Yilmaz Aylin, Kurt Didar
Аннотация
OBJECTIVES: The aim of the study was to evaluate whether non-reassuring cardiotocography (CTG) patterns or the decision-to-delivery interval is a stronger predictor of neonatal outcomes, including umbilical arterial pH and Apgar scores, in infants delivered via emergency cesarean section for suspected fetal distress.
MATERIAL AND METHODS: In this retrospective cohort study, the medical records of patients who underwent emergency cesarean delivery for suspected fetal distress were reviewed. Patients were categorized according to the type of non-reassuring CTG pattern, and the association of the decision-to-delivery interval with neonatal outcomes, including umbilical arterial pH and Apgar scores, was evaluated across groups.
RESULTS: A total of 131 patients were included in the study. The mean decision-to-delivery interval was 23.4 ± 7.6 minutes. Neonatal outcomes varied significantly across CTG categories, with the prolonged deceleration group showing the lowest umbilical arterial pH values and Apgar scores (p < 0.05). In contrast, the decision-to-delivery interval demonstrated only a weak association with neonatal outcomes, and regression models explained a limited proportion of the variance. Effect size analysis further indicated that CTG classification had a stronger influence on pH, Apgar 1, and Apgar 5 scores than the decision-to-delivery interval.
CONCLUSIONS: Cardiotocography category was a stronger predictor of neonatal acid-base status and Apgar scores than the decision-to-delivery interval in emergency cesarean deliveries for suspected fetal distress. While minimizing time to delivery remains important, greater prognostic value lies in the type of CTG abnormality observed.
MATERIAL AND METHODS: In this retrospective cohort study, the medical records of patients who underwent emergency cesarean delivery for suspected fetal distress were reviewed. Patients were categorized according to the type of non-reassuring CTG pattern, and the association of the decision-to-delivery interval with neonatal outcomes, including umbilical arterial pH and Apgar scores, was evaluated across groups.
RESULTS: A total of 131 patients were included in the study. The mean decision-to-delivery interval was 23.4 ± 7.6 minutes. Neonatal outcomes varied significantly across CTG categories, with the prolonged deceleration group showing the lowest umbilical arterial pH values and Apgar scores (p < 0.05). In contrast, the decision-to-delivery interval demonstrated only a weak association with neonatal outcomes, and regression models explained a limited proportion of the variance. Effect size analysis further indicated that CTG classification had a stronger influence on pH, Apgar 1, and Apgar 5 scores than the decision-to-delivery interval.
CONCLUSIONS: Cardiotocography category was a stronger predictor of neonatal acid-base status and Apgar scores than the decision-to-delivery interval in emergency cesarean deliveries for suspected fetal distress. While minimizing time to delivery remains important, greater prognostic value lies in the type of CTG abnormality observed.