CTG Readings - First Semester 2024-2025 PDF

Presented & Prepared by: Ms. Hannah Deva Priya Lecturer CON-A First Semester 2024-2025 · It is most commonly used in the third trimester. · Its purpose is to monitor fetal well-being and allow early detection of fetal distress. · Cardiotocography (CTG) is used...

Presented & Prepared by: Ms. Hannah Deva Priya Lecturer CON-A First Semester 2024-2025 · It is most commonly used in the third trimester. · Its purpose is to monitor fetal well-being and allow early detection of fetal distress. · Cardiotocography (CTG) is used during pregnancy to monitor the fetal heart and contractions of the uterus. · Two transducers -onto the abdomen of a pregnant woman. · One transducer records the fetal heart rate using ultrasound. · The other transducer monitors the contractions of the uterus. · FHR – Baseline Rate · V – Variability · A – Accelerations · D – Decelerations · C – Contractions O – Overall impression · Ultrasound transducer transmits the fetal heart rate in beats per minute(bpm). Ultrasound transducer :  Each small vertical squares = 10 beats / min  Each small horizontal square = 30 sec  Each large horizontal square = 1 min · The other transducer monitors the contractions of the uterus. · Transmits pressure generated by uterine contractions ◦ Each small vertical square = 10 mmHg ◦ Each small horizontal square = 30 sec ◦ Each large horizontal square = 1 min · Record the number of contractions present in a 10 minute period. · Big square is equal to one minute. · Individual contractions are seen as peaks  Example :, There are 2 contractions in a 10 minute period · Frequency- beginning of one contraction to the beginning of next contraction.( Document: no of contraction in 10 minutes) Duration –Beginning of one contraction to end of same contraction.( how long do the contractions last?) · Intensity – how strong are the contractions? (assessed using palpation) · Regularity : Interval of time/ resting time - Regular ,Irregular · Mild contraction: < 40 mm Hg · Moderate contraction: 40-80 mmHg · Severe contraction: 80- 100 mmHg · The baseline rate is the average heart rate of the fetus within a 10-minute window. · Ignore any accelerations or decelerations. · A normal fetal heart rate:110-160 bpm · Baseline variability refers to the variation of fetal heart rate from one beat to the next. · Normal variability is between 5-25 bpm. · Reassuring – 5 – 25bpm · Non-reassuring: ◦ less than 5bpm for between 30-50 minutes ◦ more than 25bpm for 15-25 minutes · Abnormal: ◦ less than 5bpm for more than 50 minutes ◦ more than 25bpm for more than 25 minutes · Accelerations are an abrupt increase in the baseline fetal heart rate of greater than 15 bpm for greater than 15 seconds. · Presence of accelerations is reassuring. · INDICATES: a healthy fetus.(FETAL WELL BEING) · Decelerations classified into three categories Early Deceleration · Late Deceleration · Variable Deceleration · · are an abrupt decrease in the baseline fetal heart rate of greater than 15 bpm for greater than 15 seconds · Decelerations are an abrupt decrease in the baseline fetal heart rate of greater than 15 bpm for greater than 15 seconds · Early decelerations start when the uterine contraction begins and recover when uterine contraction stops. · This type of deceleration is considered to be physiological and not pathological. · Due to increased fetal intracranial pressure · It quickly resolves once the uterine contraction ends and intracranial pressure reduces. · Late decelerations begin often begin just after a contraction, and recover after the contraction ends. · This type of deceleration is considered to be pathological. · Occurs due to insufficient blood flow to the uterus and placenta. (maternal hypotension from epidural, placental abruption). · Blood flow to the fetus is significantly reduced causing fetal hypoxia and acidosis. · Variable decelerations are observed as a rapid fall in baseline fetal heart rate with a variable recovery phase. · Variable decelerations are usually caused by umbilical cord compression. · They typically occur during the first and second stages of labor · Once you have assessed all aspects of the CTG you need to give your overall impression. · The overall impression can be described as either: · Reassuring · Suspicious · Abnormal  Can be described as either: · Reassuring – good fetal wellbeing · Non- Reassuring - Suspicious · Pathological –Abnormal Category Definition Normal / All the features are reassuring Reassuring Non- Reassuring One feature classified non- reassuring and remaining /Suspicious assuring Pathological Two or more features are classified as non- reassuring and one or more is abnormal.