CTG INTERPRETATION Flashcards
What is the basic pneumonic for CTG interpretation?
Dr
C.
BrA
V
A
D
O
Need for urgent
intervention
(2)
- Acute bradycardia lasting more than 9 minutes
- or a single prolonged deceleration for 3 minutes or more
Maternal Defined Risks
- Gestational diabetes
- Hypertension
- Asthma
Foetal defined risks
(8)
- Multiple gestation
- Post-date gestation
- Previous cesarean section
- Intrauterine growth restriction
- Premature rupture of membranes
- Congenital malformations
- Oxytocin induction/augmentation of labour
- Pre-eclampsia
Contractions (2)
- Duration: How long do the contractions last?
- Intensity: How strong are the contractions (assessed using palpation)?
- In the below example, there are 2 contractions in a 10 minute period (this is often referred to as “2 in 10”).
Concerning characteristics of variable Decelerations:
- lasting more than 60 seconds;
- reduced baseline variability within the deceleration;
- failure to return to baseline; biphasic (W) shape;
- no shouldering
What is normal foetal heart rate?
What is normal variability?
- 110 to 160
- 5 to 25
Causes of prolonged severe bradycardia include:
(5)
- Prolonged cord compression
- Cord prolapse
- Epidural and spinal anaesthesia
- Maternal seizures
- Rapid fetal descent
Causes of fetal tachycardia include:
(5)
- Fetal hypoxia
- Chorioamnionitis
- Hyperthyroidism
- Fetal or maternal anaemia
- Fetal tachyarrhythmia
Accelerations occurring alongside uterine contractions is a sign of a healthy/unhealthy fetus?
healthy
this is shouldering
What could the overall interpretations be?
Reassuring
non-erassuring
abnormal
What would constitute a “reassuring” overall CTG?
Baseline heart rate
- 110 to 160 bpm
Baseline variability
- 5 to 25 bpm
Decelerations
- None or early
- Variable decelerations with no concerning characteristics for less than 90 minutes
What would constitute a “abnormal” overall CTG?
Baseline heart rate
Either of the below would be classed as abnormal:
- Below 100 bpm
- Above 180 bpm
Baseline variability
Any of the below would be classed as abnormal:
- Less than 5 for more than 50 minutes
- More than 25 for more than 25 minutes
- Sinusoidal
Decelerations
Any of the below would be classed as abnormal:
- Variable decelerations with any concerning characteristics in over 50% of contractions for 30 minutes (or less if any maternal or fetal clinical risk factors – see above).
- Late decelerations for 30 minutes (or less if any maternal or fetal clinical risk factors).
- Acute bradycardia, or a single prolonged deceleration lasting 3 minutes or more.
antenatally vs intrapartum
antenatally there are no abnormal features meaning that there can’t be
if a baby
