Does cardiotocography have a role in the antenatal management of pregnancy complicated by gestational diabetes mellitus?.
Australian and New Zealand Journal of Obstetrics and Gynaecology, 56 (4), 358-363.
Background: Controversy surrounds the role of fetal cardiotocography (CTG) in the antenatal management of pregnancy complicated with gestational diabetes mellitus (GDM).
Aim: The aim was to investigate whether antenatal CTG aids the management in pregnancy complicated by GDM. Materials and Methods: A prospective audit of 1404 consecutive antenatal CTGs in women diagnosed with GDM. Outcomes for all CTGs were audited to determine if the CTGs altered pregnancy management.
Results: In women requiring combination therapy (diet and medication), 43 CTGs were required to change management of a pregnancy. In women managed by diet alone with a secondary pregnancy complication, 161 CTGs were required to change management. In women managed by diet alone with no secondary pregnancy complication, CTGs did not change management.
Conclusions: Antenatal CTGs are not recommended in women with GDM managed by diet alone with no secondary pregnancy complication. Antenatal CTGs are recommended in women with GDM who require combination therapy (diet and medication). The role of CTG in women managed by diet alone with a secondary pregnancy complication should be based upon the nature of the complication.
cardiotocography, cohort study, gestational diabetes mellitus, number needed to treat, pregnancy