Link Between Non-Invasive Intrapartum Interventions and Cardiotocography Patterns, Amniotic Fluid Color, and Immediate Neonatal Outcomes

Background: Non-invasive intrauterine resuscitation measures, such as maternal repositioning and intravenous fluid therapy, are used in the presence of suspicious or pathological cardiotocographic (CTG) patterns during labor. However, evidence regarding their link with CTG abnormalities, amniotic fluid color, and immediate neonatal outcomes is limited. Objectives: To analyze the link between maternal repositioning and intravenous fluid therapy and the occurrence of suspicious or pathological intrapartum CTG patterns, as well as their relationship with amniotic fluid color and immediate neonatal effects. Methods: An analytical, observational, prospective study was conducted in women in labor with continuous monitoring. Changes in maternal position, administration of intravenous fluid therapy, CTG patterns, amniotic fluid color, and immediate neonatal outcomes were analyzed. Links were evaluated using appropriate statistical tests, considering maternal positions in isolation and in combination. Results: Maternal repositioning, both alone and in combination, was associated with the presence of suspicious or pathological CTG and with statistically significant differences in the 5 min Apgar score when analyzed as a continuous variable. No significant association was observed between intravenous fluid therapy and CTG patterns or neonatal outcomes. The presence of meconium-stained amniotic fluid was associated with a higher frequency of suspicious or pathological CTG. Conclusions: Maternal repositioning was most frequently applied as a clinical response to a suspicious CTG. Intravenous fluid therapy showed no link with CTG abnormalities or adverse neonatal outcomes. These findings reinforce the need to interpret intrapartum CTG in an integrated manner with the overall clinical context and support the use of maternal repositioning as a non-invasive measure in intrapartum management.