Questions and Answers
Cardiotocography (CTG) is an electronic fetal monitoring?
True
External ctg put in said uterus?
False
Monitoring of the fetal heart rate and the activity of the uterine muscle is internal ctg?
False
Trasducers that put in fetal heart called ,toco, ?
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The tocodynamometer: It monitors the contractions of the uterus by measuring the tension of the maternal abdominal wall
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► Internal Cardiotocography: connected directly to the fetal scalp?
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Amniotic membranes must be ruptured ► Cervix dilated 2 cm. ► Presentation must be cephalic In external ctg?
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Intrapartum CTG Interpretation : Baseline fetal heart rate (FHR) -variability ► Presence of accelerations ► Decelerations ► (contractions)
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record the number of contractions present in a 15 minute period.
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Individual contractions are seen as peaks
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baseline fetal heart rate will usually be between 120 and 160 beats/minute.
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ascending infection, originating in the lower genitourinary tract and migrating to the amniotic cavity(Chorioamnionitis) its one of causes bradycardia
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causes of fetal tachycardia excepted:
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Is Tachyarrhythmias ► Fetal heart failure ► Severe fetal anemia, fetal hydrops ► Maternal hyperthyroidism Cause bradycardia?
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Variability: between 5 and 25 beats/minute
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ntermittent periods of reduced baseline variability are abnormal, especially during periods of quiescence ('sleep').
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All thes cause decrease variability except:
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Drug decreases variability
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Prematurity: variability is reduced at earlier gestation (<28 weeks), ► Pre-existing neurological abnormality it’s cause of increased variability?
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Increase in FHR greater than or equal to 15 bpm, for greater than or equal to 15 seconds from the onset to return to baseline is acceleration’s
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presence of accelerations, generally a sign that the baby is healthy, digital fetal scalp stimulation sign that the baby is healthy
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Decreases in fetal heart rate from the base line by at least 15b/m, lasting for at least 15 seconds is decelerations
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Early decelerations are a benign( kind/ gentle) finding caused by a vasovagal response as a result of fetal head compression by the contraction.
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Early declaration and contraction at the same level in gram
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Concerning characteristics of variable decelerations
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(The accelerations before and after a variable deceleration are known as the shoulders of deceleration. Their presence indicates the fetus is not yet hypoxic and is adapting to the reduced blood flow) ……..if not found it’s not concerning?
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Late Decelerations: Onset of the decleration occurs after the beginning of the contraction(not on the same position in gram), and the nadir of the deceleration occurs after the peak of the contraction.
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We use EFM/CTGM in all the following except:
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Intermittent auscultation of the fetal heart rate to women at low risk of complications in established second stage of labour?
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ermittent auscultation immediately after a contraction for at least 1 minute, at least every 15 minutes in the first stage of labour and and at least every 5 minutes in the second stage and record it as a single rate.
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Maternal medical illness ,Gestational diabetes, Hypertension ,Asthma. ► Obstetric complications : Multiple gestation ,Post-date gestation ,Previous cesarean section ,Intrauterine growth restriction ,Oligohydramnios ,Premature rupture of the membranes, Congenital malformations ,Third-trimester bleeding. ► Oxytocin induction/augmentation of labor, Preeclampsia ,Meconium stained liquor……………………High-Risk pregnancies need continuous FHM :??
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We Continuous cardiotocography if this risk factors found:
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In categories ctg:
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CTG is normal: continue CTG, remove CTG after 20 minutes i
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If suspicious: commence conservative measures – left lateral position, oral/intravenous fluids, stop oxytocin, consider tocolysis.(to delay delivery)
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the CTG is abnormal: Offer to take fetal blood sample (FBS; for lactate or pH) after implementing conservative measures, or expedite birth if an FBS cannot be obtained and no accelerations are seen as a result of scalp stimulation.
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The pH of the fetus has been shown to drop at the rate of 0.01 every 2–3 minutes. This afraid sign
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Normal(PH:>=7.25)(second fetal blood sample no more than 1 hour)…………Borderline (PH 7.24-7.21):(mild acidosis)(taking a second fetal blood sample no more than 30 minutes l)………….. Abnormal (PH<7.2) : Delivery.
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Sinusoidal CTG
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Sinusoidal CTG: if present it is very concerning as it is associated with high rates of fetal morbidity and mortality.1
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sinusoidal pattern usually indicates all of the following except:
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