CTG

Question 1

Outline the reassuring features of a CTG?

Answer 1

Baseline rate: 110-160 - Might be lower if >40 weeks
Variability: > 5 bpm - Could be less if baby is asleep
Accelerations: Present - Sign of foetal movement
Decelerations: None - May drop during contractions, but this is normal

Question 2

What is baseline bradycardia a sign of?

Answer 2

<100 bpm 
Increased foetal vagal tone
Hypoxia
Post-term
Mother on b-blockers
Maternal parasympathetic innervation

Question 3

What is baseline tachycardia a sign of?

Answer 3

Baseline tachycardia (>160 bpm) - Maternal pyrexia, chorioamnionitis, hypoxia, prematurity

Question 4

What is loss of baseline variability a sign of?

Answer 4

< 5bpm

If less than 40 minutes, baby is likely asleep, if more than 40 minutes, could be due to hypoxia

Question 5

What are early decelerations a sign of?

Answer 5

Normally innocuous and is caused by head compression during contraction

Question 6

What are late decelerations a sign of?

Answer 6

Deceleration than does not return to normal until 30 seconds after deceleration)

Foetal distress as a result of asphyxia or placental insufficiency

Question 7

What is a prolonged deceleration a sign of?

Answer 7

A deceleration lasting 3 minutes or more is considered abnormal, could indicate hypoxia

Question 8

What are variable decelerations a sign of?

Answer 8

Decelerations that are not related at all to contractions

Could indicate cord compression

Question 9

What measures can be taken to see whether a suspicious CTG trace will improve during labour?

Answer 9

Switch off syntocinon

Move to the left lateral position