Non-reassuring foetal status is a relatively common finding in labour theatre where a normal pregnancy can turn into a high-risk situation. Non-reassuring foetal status is due to foetal hypoxia and metabolic acidosis. (1).The most common indication for emergency caesarean section is Nonreassuring fetal status (NRFS)(2). Cardiotocography is widespread used to detect foetal status. The cardiotocography pattern associated with Non-reassuring foetal status are well correlated with foetal status during emergency Cesaerean section done for non reassuring foetal status. We undertook this study to correlate abnormal CTG & intraoperative findings like meconium-stained liquor, cord around the neck of the foetus in patients undergoing Caesarean section for non-reassuring foetal status on Cardiotocography AIM: Correlate non reassuring CTG findings with intraoperative findings during emergency caesarean sections for non-reassuring fetal status

Source of data: Department of Obstetrics and Gynaecology, Subbaiah Institute of Medical Sciences, Shivamogga Study Design: observational study Duration: 6 months Period of collection of data: from March to August 2025 An observational study included 49 term women with singleton pregnancies undergoing emergency caesarean for non-reassuring CTG from March 2025 to August 2025. CTG was correlated Intraoperative findings like meconium-stained liquor and nuchal cord and APGAR score at birth & at 5 min.

Out of these 49 who underwent emergency caesarean section for non-reassuring fetal status, 30 primigravida & 19 multigravida. 61.23% had CTG with decelerations; 38.77% had decreased variability. In the deceleration group, 56.67% had meconium-stained liquor and 33.33% had nuchal cord; in the decreased variability group, 57.89% had meconium and 36.84% had nuchal cord. A small percentage (8.16%) showed no intraoperative abnormalities. Table 1: Gravidity Gravida Number Percentage 1 30 61.22% >/=2 19 38.77% In this study, majority of primigravidae(61.22%) underwent caesarean section Table 2: Non-reassuring CTG & intra op findings Intra op findings Deceleration Decreased beat to beat variability Meconium stained liquor 17 (56.67%) 11 (57.89%) Nuchal cord 10(33.33%) 07 (36.84%) No findings 03 (10%) 01 (5.27%) Total 30(61.23%) 19 (38.77%) 61.23% had CTG with decelerations; 38.77% had decreased variability. In the deceleration group, 56.67% had meconium-stained liquor and 33.33% had nuchal cord; in the decreased variability group, 57.89% had meconium and 36.84% had nuchal cord. A small percentage (8.16%) showed no intraoperative abnormalities. TABLE 3 APGAR at birth <5 5 (10.2%) 6-8 18 (36.73%) 8-10 26 (53.07%) Total 49 APGAR at 5min <5 5(10.2%) 6-8 6(12.24%) 8-10 38(77.56%) Total 49 Among 49 newborns, APGAR scores improved from birth to 5 minutes. High scores (8–10) increased from 53.07% to 77.56%, while intermediate scores (6–8) decreased from 36.73% to 12.24%. Low scores (<5) remained constant at 10.2%, indicating improved neonatal status with early intervention. Only 5 (10.2%) newborns admitted to NICU

All study findings consistently show that abnormal CTG—especially decreased variability and decelerations—correlates strongly with fetal distress indicators such as meconium-stained liquor, nuchal cord, and low Apgar scores (1)(2)(4) In our study it shown that pregnant women who underwent Emergency LSCS for fetal distress, 61% were primigravidae. Aligning with similar trends reported in previous research(1) . Decelerations (61%) and reduced variability (39%) were the main CTG abnormalities, aligning with other studies. Meconium (56–58%) and nuchal cord (33–37%) were frequent intra-operative findings confirming fetal compromise Neonatal outcomes were favorable: low Apgar (<7) in ~10%, NICU admission 10.2%, and no mortality, all lower than in comparable studies—reflecting early recognition and prompt intervention

CTG abnormalities often correlate with intraoperative findings but are not always predictive of fetal distress. Most infants recovered well post-delivery, indicating that while CTG is a useful screening tool, clinical correlation is essential to prevent unnecessary interventions.

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