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Understanding Cardiotocography (CTG) in Pregnancy Monitoring

• CTG stands for cardiotocography and is used to monitor fetal heart rate and uterine contractions during pregnancy.
• CTG is most commonly used in the third trimester and can detect fetal distress.
• Two transducers are placed on the pregnant abdomen to record fetal heart rate and monitor uterine contractions.
• The monitor displays the fetal heart rate and tocometry measurement, and can also measure maternal parameters like blood pressure and heart rate.
• CTGs are printed on graph paper with the fetal heart trace on the top and tocometry trace below.
• The graph paper is divided into 10-minute blocks, represented by 10 small boxes, with each small box representing one minute.
• CTG interpretation is structured using the mnemonic "DR C BRAVADO", which stands for Defined risk, Contractions, Baseline rate, Variability, Accelerations, Decelerations, and Overall impression.
• "Defined risk" assesses the risk factors of the pregnancy, such as high-risk factors or intrauterine growth restriction.
• "Contractions" assesses the frequency and duration of contractions, with four to five contractions in 10 minutes being ideal during labor.
• "Baseline rate" refers to the average fetal heart rate, with normal range being 110 to 160 beats per minute.
• "Variability" refers to the variation in fetal heart rate from one beat to the next, with normal range being 5 to 25 beats per minute.
• "Accelerations" are abrupt increases in fetal heart rate by more than 15 beats per minute for more than 15 seconds, indicating a healthy fetus.