CTG Interpretation Quiz & Flashcards for Mastery

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Questions and Answers

What is the primary purpose of Electronic Fetal Monitoring (EFM)?

To identify intrapartum hypoxia (correct)

To monitor maternal heart rate

To assess fetal weight

To increase rates of cesarean section

In which situation should intermittent auscultation be performed during labor?

Only in high-risk pregnancies

During the second stage of labor only

In all pregnancies regardless of risk

In low-risk women during established first stage of labor (correct)

Which of the following is NOT considered a high-risk condition that requires continuous fetal heart monitoring?

Premature rupture of membranes

Gestational diabetes

Hypertension

Low maternal age (correct)

What is the recommended frequency for palpating the maternal pulse during labor?

Once every hour, or more often if needed Signup and view all the answers

Which of the following is an indication for using continuous fetal heart monitoring?

Multiple gestation Signup and view all the answers

Why should Electronic Fetal Monitoring not be used indiscriminately?

It can lead to unnecessary procedures in low-risk women Signup and view all the answers

Which maternal pulse rate indicates the need for continuous cardiotocography?

Over 120 beats/minute Signup and view all the answers

What temperature reading triggers continuous cardiotocography?

38.0°C or above Signup and view all the answers

What does a reading of 2+ protein on urinalysis indicate in conjunction with elevated blood pressure?

Continuous cardiotocography is required Signup and view all the answers

What characterizes a 'suspicious' cardiotocography trace?

One non-reassuring feature and two reassuring features Signup and view all the answers

Which of the following conditions would not require continuous cardiotocography?

Normal maternal pulse rate Signup and view all the answers

What is an appropriate management step if cardiotocography is 'suspicious'?

Commence conservative measures Signup and view all the answers

How long can a continuous cardiotocography monitor be removed if no non-reassuring features are present?

After 20 minutes Signup and view all the answers

What indicates that fetal acidosis is unlikely in a suspicious cardiotocography trace?

Presence of accelerations Signup and view all the answers

What is the primary purpose of cardiotocography (CTG)?

To continuously record the fetal heart rate. Signup and view all the answers

What is monitored using a tocodynamometer (toco)?

Uterine contractions. Signup and view all the answers

Which condition must be met for internal cardiotocography to be performed?

Amniotic membranes ruptured. Signup and view all the answers

What is the normal baseline fetal heart rate range?

110 to 160 beats/minute. Signup and view all the answers

How is fetal heart rate monitored during external cardiotocography?

Using two transducers placed on the mother's abdomen. Signup and view all the answers

What does the presence of accelerations in a CTG indicate?

Healthy fetal well-being. Signup and view all the answers

How should the number of contractions be recorded on a CTG chart?

By recording the peaks over a 10-minute period. Signup and view all the answers

What does a baseline FHR variability indicate?

It reflects the normal functioning of the fetal autonomic nervous system. Signup and view all the answers

What is defined as fetal tachycardia?

Baseline FHR greater than 160 beats per minute Signup and view all the answers

Which of the following is NOT a cause of fetal tachycardia?

Maternal hypothyroidism Signup and view all the answers

What is the typical range of normal variability in fetal heart rate?

5 to 25 beats per minute Signup and view all the answers

Which condition can lead to decreased fetal heart rate variability?

Fetal acidosis due to hypoxia Signup and view all the answers

What characteristic is NOT associated with concerning variable decelerations?

Gradual decrease in FHR Signup and view all the answers

What defines late decelerations in fetal heart rate monitoring?

Onset occurs after the beginning of the contraction Signup and view all the answers

What is a potential cause of fetal bradycardia?

Fetal heart failure Signup and view all the answers

Which drug is associated with decreased fetal heart rate variability?

Magnesium sulfate Signup and view all the answers

Study Notes

Cardiotocography (CTG)

Cardiotocography provides continuous electronic recording of fetal heart rate (FHR) through transducers on the mother’s abdomen.
Also known as electronic fetal monitoring, it assesses fetal well-being during labor.

External Cardiotocography

Involves continuous or intermittent monitoring of fetal heart rate and uterine activity.
Utilizes two transducers: one over the fetal heart and one at the uterine fundus for monitoring contractions (via a tocodynamometer).

Internal Cardiotocography

Requires direct connection to the fetal scalp through the cervical opening.
Conditions for use include ruptured membranes, a cervix dilated to 2 cm, and a cephalic fetal presentation.

Key Components of CTG Interpretation

Baseline fetal heart rate (FHR) should be 110-160 beats/minute.
Variability of the baseline FHR usually ranges from 5 to 25 beats/minute.
Presence of accelerations and decelerations informs about fetal condition.
Monitoring uterine contractions is crucial for understanding labor progress.

Contractions Assessment

Count number of contractions in a 10-minute interval, represented as peaks on CTG.

Fetal Heart Rate Characteristics

Fetal tachycardia: Baseline FHR over 160 beats/minute, potentially caused by maternal fever, chorioamnionitis, or fetal sepsis.
Fetal bradycardia: Sustained FHR less than 110 beats/minute.

Fetal Heart Rate Variability

Normal variability indicates a well-oxygenated fetus; decreased variability may suggest fetal distress or conditions like fetal acidosis.

Decelerations

Variable Decelerations: Sudden drops in FHR, often related to cord compression, concerning if last more than 60 seconds or show reduced baseline variability.
Late Decelerations: Gradual decrease in FHR occurring after contraction, indicating possible uteroplacental insufficiency.

Risk Factors Requiring Continuous FHM

High-risk pregnancies due to maternal medical conditions (e.g., diabetes, hypertension), obstetric complications (e.g., multiple gestation), or events like severe hypertension or significant meconium presence.

Continuous CTG Monitoring Conditions

Maternal pulse over 120 beats/minute or elevated temperature can indicate the need for continuous monitoring.

CTG Trace Categorization

Normal: All reassuring features present.
Suspicious: One non-reassuring feature with two reassuring features.
Pathological: One abnormal feature or two non-reassuring features.

Management Based on CTG Interpretation

If CTG is normal: Maintain monitoring or discontinue if there are no concerning features after 20 minutes.
If suspicious: Implement conservative measures (e.g., left lateral position, fluid administration, consider tocolysis).

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Description

Test your knowledge on Cardiotocography (CTG) interpretation with this quiz. Discover the key concepts of fetal heart rate monitoring and the methods used for effective assessment. Perfect for medical students and professionals interested in obstetrics.

CTG Interpretation Quiz