Fetal monitoring I Flashcards
List some methods of intermittent auscultation?
Pinard stethoscope (cone shaped)
Hand-held Doppler device
What are the disadvantages of intermittent auscultation?
Can’t monitor long term
Can’t detect variability and decelerations
Quality affected by maternal HR and movement
List some methods of continuous monitoring?
Cardiotocography
Scalp ECG
Abdominal fetal ECG
What does CTG stand for? What does it measure?
Cardiotocography
Fetal heart rate and uterine contractions
What are some advantages of intermittent auscultation?
Inexpensive
Non-invasive
Can be used at home
What are some disadvantages of CTG?
No morphological assessment of the heart
No true beat to beat fetal HR data
Not ambulatory
What do you look at when interpreting a CTG?
Dr C BraVADO
Dr: define risk
C: contractions
Bra: baseline rate
V: variability
A:accelerations
D:decelerations
O: overall
What’s the normal range of fetal heart rate?
110-160bpm
What does it mean if on a CTG you see variability is less than 5?
At what point would you get worried?
The baby could be asleep
If this lasts for longer than 40 mins then this is worrying
You see accelerations on the CTG, are you worried?
No, this is normal
There are 3 types of deceleration, describe them. Are they worrying or not?
Early: FHR drops during uterine contraction (mirror image)
This is normal
Late: FHR drops after uterine contraction
This is very worrying
Variable: FHR drops with no relationship to uterine contractions
This is worrying
What causes early decelerations on a CTG?
FHR drops as uterus contracts.
Due to head compression
What are non-reassuring features on a CTG?
Baseline 100-109 or 161-180
Variability <5bpm for 40-90 mins
Variable decelerations
What are reassuring features on a CTG?
Baseline 110-160
Variability > 5bpm
Accelerations present
Early decelerations
What are abnormal features on a CTG?
Baseline less than 100 or greater than 180
Variability <5bpm for 90mins +
Late decelerations
