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WACS > CARDIOTOCOGRAPHY > Flashcards

CARDIOTOCOGRAPHY Flashcards

1
Q

Contributory factors to fetal morbidity and mortality following CTG

A
  1. CTG technique/equipment
  2. Errors of interpretation of CTG
  3. Failure to act upon suspicion of pathological CTG
  4. Fetal blood sampling
  5. CTG and blood sampling–other
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2
Q

T/F: Staff tasked with CTG interpretation must have evidence of annual training

A

T

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3
Q

T/F: Key management decisions should not be based on CTG alone

A

T

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4
Q

Monitoring tool to identify hypoxia

A

`Cardiotocograph

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5
Q

T/F: CTG during labour is associated with reduced rates of neonatal seizures

A

T

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6
Q

T/F: increase in caesarean sections and instrumental vaginal births with CTG in labour

A

T

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7
Q

T/F: with CTG there is no clear differences in cerebral palsy, infant mortality or other standard measures of neonatal wellbeing.

A

T

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8
Q

CTG pattern with stress

A
  1. Hypoxia begins with deceleration
  2. Acceleration disappear
  3. Baseline HR increases
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9
Q

CTG pattern with compensated stress

A
  1. Stable baseline
  2. normal variability
  3. deceleration deeper and wider
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10
Q

CTG pattern with decompensation

A
  1. Unstable Baseline
  2. changes in variability
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11
Q

4features of fetal heart rate

A
  1. Baseline rate
  2. Baseline variability
  3. Presence or absence of decelerations (and concerning characteristics of variable decelerations if present)
  4. Presence of accelerations
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12
Q

T/F: If there is a stable baseline fetal heart rate between 110and 160beats/minute and normal variability, continue usual care as the risk of fatal acidosis is low

A

T

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13
Q

T/F:The presence of fetal heart rate accelerations, even with reduced baseline variability, is generally a sign that the baby is healthy

A

T

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14
Q

Normalbaseline rate is

A

110 – 160 bpm

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15
Q

T/F: Baseline HR is gestation dependent

A

T

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16
Q

Non reassuring baseline rate are –and –

A

baseline bradycardia and baseline tachycardia

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17
Q

Baseline bradycardia is

A

100 - 109 bpm

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18
Q

Baseline tachycardia is

A

160 - 179bpm

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19
Q

AbnormalHR

A

<100 bpm
>180 bpm

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20
Q

Acceleration is

A

Increase in FHR above baseline of at least 15bpm for at least 15seconds

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21
Q

T/F: Absence of FHR acceleration is a good predictor of fetal metabolic acidemia or hypoxic injury

A

F. Poor predictor

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22
Q

Single most helpful method of assessing a fetus

A

Variability

23
Q

T/F: Represents integrated activity of the autonomic nervous system

A

T

24
Q

T/F: Tends to be reduced during spells of quiet sleep

A

T

25
Q

Abnormal variability is

A

Reduced variability with decelerations

low or high baseline rate

26
Q

Normal variability

A

Between 5 and 25 bpm

27
Q

Increased variability

A

> 25 bpm

28
Q

Reduced variability

A

2 - 5 bpm

29
Q

Absent variability

A

< 2 bpm

30
Q

Types of variability

A

Normal, increased, reduced and absent

31
Q

Deceleration is

A

Drop in baseline of at least 15bpm, lasting at least 15 seconds

32
Q

Types of decelerations

A

early, late and variable

33
Q

A temporary decrease in fetal heart rate below the baseline

A

Deceleration

34
Q

T/F: Deceleration may be obvious (deep and broad) or subtle (shallow)

A

T

35
Q

Fetal autonomic response to changes in intracranial pressure and/or cerebral blood as a result head compression in labour.

A

Early deceleration

36
Q

reflex fetal response to transient hypoxemia during uterine contraction

A

Late deceleration

37
Q

fetal autonomic reflex response to mechanical compression of the umbilical cord

A

Variable deceleration

38
Q

No Concerning characteristics with variable decelerations are –, –, – and –

A
  1. lasting less than 60seconds
  2. baseline variability maintained within the deceleration
  3. shouldering
  4. V shape
39
Q

Concerning characteristics with variable decelerations

A
  1. lasting more than 60seconds
  2. reduced baseline variability within the deceleration
  3. failure to return to baseline
  4. biphasic (W) shape
  5. no shouldering
40
Q

T/F: Shallow decelarations are more ominous compared to deep decelarations

A

T

41
Q

Rare and associated with fetal anaemia and hypoxia.

A

Sinusoidal pattern

42
Q

A regular oscillation of the baseline long-term variability resembling a sine wave

A

Sinusoidal pattern

43
Q

Characteristics of sinusoidal pattern

A
  1. a smooth undulating pattern
  2. 3-5cycles per minute
  3. Amplitude 5-15bpm
  4. No acceleration
  5. Persist at least 20 minutes
44
Q

How long should a CTG trace be stored

A
  1. 25 years
  2. In cases where there is concern that the baby may experience developmental delay, photocopy CTG traces and store them indefinitely in case of possible adverse outcomes.
45
Q

T/F: Antenatal CTG can be performed from 24 weeks

A

F. Not done prior to 26 weeks

46
Q

T/F: Computerised CTG is not appropriate for intrapartum fetal monitoring

A

T.
NOT appropriate for intrapartum fetal monitoring. It is not valid if the woman is experiencing regular uterine contractions, or when she is in the latent phase of labour. It can be used prior to the administration of Propess, but not after it has been administered.

47
Q

T/F: A short-term variation (STV) value of less than 3ms is strongly linked to the development of metabolic acidemia and impending intrauterine death

A

T

48
Q

Dawes Redman Criteria
DRC met =

A

Normal CTG
Criteria can be met as early as 10minutes and CTG discontinued before 20minutes

49
Q

DRC not met –

A

continue CTG for full 60minutes
Codes for why criteria not met

50
Q

5 maternal indications for intrapartum CTG

A

Antepartum haemorrhage
Significant meconium
Oxytocin use
Suspected chorioamnionitis, sepsis
PET ( severe HTN , proteinuria)

51
Q

5 fetal indications for intrapartum CTG

A

Cord presentation
Abnormal presentation – breech, transverse
Fetal growth restriction
Deceleration heard on IA

52
Q

Suspicious CTG is

A

2 normal features plus one non reassuring feature

53
Q

Features of a non reassuring CTG

A
  1. Baseline of 100 - 109 or 161 -180
  2. Variability of <5bpm for 30 mins or >25bpm for 15 mins
  3. Read up the decelerations
54
Q

Features of pathological CTG

A
  1. Baseline below 100 or > 180
  2. Variability of <5bpm for 50 mins or >25bpm for 25 mins
  3. Read up the decelerations

WACS (19 decks)

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