Z2F Obstetrics

Question 1

Where is the CTG placed

Answer 1

One over fundus for contractions

One over foetal heart

Question 2

Indications for continuous CTG

Answer 2

Sepsis, oxytocin infusion, mum tachycardia, pre-eclampsia, APH, delay in labour, disproportionate maternal pain

Question 3

Mnemonic for CTG

Answer 3

DR C BRaVADO

Question 4

Meaning of accelerations

Answer 4

reassuring especially when during a contraction

Question 5

Reassuring baseline rate

Answer 5

110-160

Question 6

Reassuring variability

Answer 6

5-25

Question 7

4 types of deceleration

Answer 7

Early, late, variable and prolonged

Question 8

Early decelerations:

Answer 8

Normal
Lowest point corresponds to peak of contractions
Uterus compresses head of fetes stimulating vagus nerve

Question 9

Late decelerations:

Answer 9

Concerning - sign of fetal hypoxia

Question 10

Variable decelerations:

Answer 10

Compression of umbilical cord - accelerations before and after, shouldering, is reassuring that fetus is coping

Less than 2 mins - can be normal

Question 11

Prolonged decelerations:

Answer 11

Last more than 2 mins

Always abnormal and concerning

Question 12

4 NICE categories for CTG

Answer 12

normal, suspicious (1 feature), pathological (2 features), need for urgent intervention (fetal Brady or >2 min decelerations)

Question 13

Rule if fetal bradycardia

Answer 13

3’s

3 mins - call for help
6 mins - move to theatre
9 mins - prepare to deliver
12 mins - deliver

Question 14

Sinusoidal CTG

Answer 14

Looks like a sine wave - very concerning

Caused by severe anaemia