Intrapartum Monitoring (1*)

Question 1

DR C BRaVADO:
What does DR stand for?

What does C stand for?

What does BRa stand for?
→ What are the causes of Tachycardia?
→ What are the causes of Bradycardia?
→ What sign indicates Complete heart block?

Answer 1

➊ Define Risk = Low/High

➋ Contractions = Frequency (NR 4-5 every 10 mins)

➌ Baseline Rate = Tachy/Bradycardia (NR 110-160 bpm)
→ Maternal pyrexia or stress, Drugs (atropine, tocolytics), Infection, Dehydration, Prematurity, Hypoxia
→ Foetal hypoxia (cord compression, placental abruption), Drugs (benzos), Congenital heart disease, Foetal heart block
→ Brady + Decreased variability

Question 2

What does the V stand for?
→ What does it represent?
→ What causes a reduced variability?

What does the A stand for?
→ What is it?
→ What is it associated with?

Answer 2

➊ Variability = Degree to which baseline varies (NR 10-25 bpm)
→ The integrity of the Autonomic NS
→ Sleepy baby (normal for 20-40 mins), Narcotics, Foetal anomalies, Hypoxia

➋ Accelerations – Normally a good sign
→ Rise in baseline by >15, lasting over 15 secs
→ Foetal movements or stimulation

Question 3

What does the D stand for?
→ What is it?
→ What is important to ascertain with it?
→ What is a cause of an Early deceleration?
→ What is a cause of a Late deceleration?
→ What is a cause of a Variable deceleration?

What does the O stand for?

Answer 3

➊ Decelerations
→ Drop in baseline by >15, lasting over 15 secs
→ Are they periodic (With contractions – Early/Late/Variable) or episodic (Anytime)
→ Head compression
→ Uterine contraction, Uteroplacental insufficiency (Usually pathological and due to Hypoxia)
→ Cord compression → Gradually developing hypoxia
• Vein constricted → Foetal hypotension + Tachycardia
• Artery constricted → Foetal hypertension + Bradycardia

➋ Overall impression = Is the CTG Reassuring, Non-reassuring or Abnormal?