CTG

Question 1

CTG - what does it measure

Answer 1

fetal heartrate

uterine contractions

Question 2

indications for continuous CTG monitoring

Answer 2

sepsis 
maternal tachycardia
signif meconium
PET 
fresh APH 
delay in labour
oxytocin use 
bad maternal pain

Question 3

key features to assess on CTG

Answer 3

contractions - no in 10min
baseline rate
variability 
accelerations
decelerations

Question 4

contractions

Answer 4

used to gauge activity of labour

too few - not progressing
too many - uterine hyperstimulation

Question 5

acceleartions

Answer 5

good sign fetus is healthy

esp when occur alongside contractions

Question 6

baseline rate - reassuring

Answer 6

110-160

Question 7

baseline rate - non-reasuring

Answer 7

100-109
or
161-180

Question 8

baseline rate - abnormal

Answer 8

< 100

> 180

Question 9

variability - reassuring

Answer 9

5-25

Question 10

variability - non-reassuring

Answer 10

< 5 for 30-50min
or
>25 for 15-25min

Question 11

variability - abnormal

Answer 11

< 5 for > 50min
or
> 25 for >25mins

Question 12

decelerations

Answer 12

can be concerning

fetal HR drops in response to hypoxia

Question 13

early decelerations

Answer 13

gradual dips - lowest point corresponds to peak of contraction

normal

Question 14

late decelarations

Answer 14

gradual falls in HR after contraction
lowest HR is afer contraction peak

caused by fetal hypoxia and are concerning

Question 15

variable decelerations

Answer 15

abrupt decelerations can be unrelated to contractions

brief accelerations before and after the decelation are reassuring

Question 16

prolonged decelerations

Answer 16

2-10mins

indicates compression of umbilical cord and is concerning

Question 17

devecelerations - what is non-reassuring or abnormal

Answer 17

regular variable decelerations
late decelerations
prolonged decelerations

Question 18

4 categories of CTG

Answer 18

normal
suspicious
pathological
need for urgent intervention

Question 19

suspicious CTG

Answer 19

1 non-reassuring factor

Question 20

pathological CTG

Answer 20

2 non-reassuring factors
or
1 abnormal feature

Question 21

need for urgent intervention CTG

Answer 21

acute bradycardia
or
prolonged deceleration >3min

Question 22

fetal bradycardia - rule of 3

Answer 22

3 min - call for help
6 min - move to theatre
9 min- prepare for delivey
12min - delivery baby

Question 23

sinusoidal CTG

Answer 23

indicate severe fetal comrpomise

sine wave with smooth regular waves amplitude 5-15bmp

Question 24

sinusoidal CTG - assoc w

Answer 24

severe fetal anaemia e.g. vasa praevia

Question 25

DR C BRaVADO

Answer 25

DR : define risk 
C: contractions
BRa: Baseline rate 
V: variability 
A: accelerations
D: decelerations 
O: overall impression