Cardiotocography (CTG) is a cornerstone of intrapartum fetal monitoring but requires a minimum of 30 minutes for a reliable trace, creating a significant bottleneck in high-volume, low-resource settings like Egypt As it is time-consuming and resource intensive. This leads to delays in care and increased workload for healthcare providers. A shortened, yet accurate, CTG protocol could drastically improve workflow and resource allocation without compromising fetal safety.

In Egypt, labor wards in tertiary hospitals are often overcrowded with limited CTG machines and midwives. The requirement of a minimum 30-minute CTG trace creates bottlenecks in care and increases staff workload. Previous studies suggest that the first 10 minutes of a CTG may capture the essential features of fetal well-being. If validated, a shortened CTG could improve efficiency in high-volume maternity units without compromising neonatal outcomes. Using umbilical venous pH as the gold standard for fetal acid-base status, this study will directly compare the diagnostic accuracy of a 10-minute versus a 30-minute CTG protocol in low-risk laboring women. The aim is to evaluate whether a 10-minute CTG tracing is non-inferior to the standard 30 minute CTG in fetal assessment and predicting fetal acid-base status (umbilical venous pH) in term, low-risk pregnancies during the active first stage of labor.

Inclusion Criteria:

• Singleton pregnancy.
• Gestational age ≥ 37 weeks.
• Vertex presentation.
• Active first stage of labor (cervical dilation ≥ 4 cm).
• Low-risk pregnancy (no hypertension, diabetes, IUGR, or other significant complications).

Exclusion Criteria:

• • Multiple gestation.

  • Known major fetal anomaly.
  • Non-vertex presentation.
  • Indication for continuous CTG (e.g., meconium-stained liquor, antepartum hemorrhage).
  • Maternal refusal.

Pregnant women only with full term pregnancy

All women who come to Women's Health Assiut university hospital in labor and meet the inclusion criteria after informed consent.