CTG Quiz: Test Your Knowledge on Monitoring

Study Notes

CTG Questions and Answers

Question 1: What is a CTG?
- Answer: A cardiotocograph (CTG) is a non-invasive monitoring technique used to track the fetal heart rate (FHR) and uterine contractions during pregnancy, typically in the third trimester.
Question 2: What are the key components of a CTG tracing?
- Answer: A CTG tracing shows the fetal heart rate (FHR) and the uterine contractions (UCs). The FHR is measured in beats per minute (bpm), and UCs are measured in mmHg and duration of contraction in seconds.
Question 3: What are some common fetal heart rate (FHR) patterns?
- Answer: Variations exist across pregnancy. Periodic patterns include accelerations, decelerations, and baseline variability. Baseline variability can be categorized as absent, minimal, moderate, or marked.
Question 4: How do accelerations differ from decelerations?
- Answer: Accelerations are FHR increases lasting at least 15 bpm above the baseline for at least 15 seconds. Decelerations are FHR decreases from the baseline. Early, late, and variable are the types of decelerations.
Question 5: What clinical significance do abnormal CTG patterns hold?
- Answer: Abnormal patterns can indicate fetal compromise, distress, or hypoxia. Late decelerations are a crucial concern, signaling potential uteroplacental insufficiency.
Question 6: What are examples of fetal heart rate (FHR) abnormalities found in CTGs?
- Answer: FHR abnormalities can include excessive variability, sinusoidal pattern, bradycardia (slow heart rate), tachycardia (fast heart rate), and non-reassuring patterns such as late decelerations, variable decelerations (often associated with umbilical cord compression), and prolonged decelerations.

CTG Interpretation

Baseline FHR: The average FHR over 10 minutes, excluding accelerations and decelerations. Normal range is 110-160 bpm.
Baseline Variability: Fluctuations in the baseline FHR. It reflects the activity of the fetal autonomic nervous system. Moderate variability is reassuring, and decreased variability is a cause for concern, suggesting potential fetal compromise.
Accelerations: Increases in the FHR lasting at least 15 bpm above the baseline for at least 15 seconds, usually in response to fetal movement or fetal well-being.
Decelerations: Decreases in the FHR. Early decelerations are typically benign, while late decelerations and variable decelerations are associated with potential fetal distress.
Uterine Contractions (UCs): Frequency, duration, and intensity of uterine contractions. Information about these can aid in interpretation of decelerations in association with other factors.

Fetal Heart Rate Patterns

Category I: These patterns are reassuring and do not indicate fetal compromise. They are associated with normal fetal acid-base status.
- Characteristics often include moderate baseline variability, accelerations, and absence of decelerations.
Category II: These patterns require further assessment. They could be reassuring or concerning, and more observations or interventions may be needed.
- Characteristics include patterns like minimal baseline variability, bradycardia, tachycardia, absence of accelerations, or more than one type of deceleration that is considered non-reassuring.
Category III: These patterns are non-reassuring and suggest potential fetal compromise. Prompt intervention is necessary.
- Characteristics include absent baseline variability, recurrent late decelerations, bradycardia, and/or sinusoidal pattern.

Clinical Significance

Fetal compromise: Unusual CTG patterns can suggest fetal compromise, potentially indicating problems with oxygen delivery to the fetus. This could involve issues with the placenta, umbilical cord, or the mother's blood pressure.
Intervention: Identifying non-reassuring patterns requires prompt and appropriate interventions, like changing maternal position, administering oxygen, or performing a C-section.
Monitoring: Continuous CTG monitoring allows for evaluation of fetal status throughout pregnancy, allowing potential issues to be identified quickly, ensuring fetal health is prioritized.

Description

Test your knowledge on cardiotocography (CTG) with this quiz. Explore the key components of CTG tracing, understand fetal heart rate patterns, and learn the differences between accelerations and decelerations. Perfect for those studying obstetrics and maternal-fetal medicine.