Sunday, February 7, 2021

Cardiotocography

 CARDIOTOCOGRAPHY


CTG machine has two sensors:

 

  • Cardio probe: placed on the mother’s abdomen at the foetal anterior shoulder to measure the foetal heart rate. 


  • Toco probe: placed on the mother’s fundus to record uterine muscle contraction.  

(Jelly is to be applied between the probe and the site of application of the probe)


 

CTG paper moves at rate of 3cm/min 

Therefore 1cm = 20 sec on x-axis

        

Also 1 cm = 10 bpm on Y axis


To be taken every 2 hours towards the end of pregnancy.


 When analysing a CTG look for 4 things:

  1. Baseline heart rate

  2. Beat to Beat variability 

  3. Accelerations

  4. Decelerations 




  1. Foetal Heart rate: Normal: 110-160 bpm 

  2. Beat to beat variability:  Normal: 5-25bpm showing saw tooth pattern      

  3. Foetal accelerations: 

  • Abrupt increase in FHR above baseline. 

  • If a rise of 15 bpm persists for 15 sec or more but less than 2 mins is seen twice during a 20 min period then this is adequate contractions or REACTIVE (after 32 weeks). 

 

  1. Foetal decelerations: 

  • Decrease of 15 bpm in FHR for ≥15 seconds  

  • Time from onset of the deceleration to the lowest point of the deceleration >30 seconds in variable decelerations.






  • Early decelerations: Cause: pressure on the foetal head during labour (normal)

 

  • If late or variable decelerations are present, call a senior. 


  • If all 4 parameters normal: REASSURING NST

  • If any 1 abnormal: SUSPICIOUS NST 

  • If any 2 or more abnormal: PATHOLOGICAL NST 


 

If CTG is non-reassuring

  • Set up IV line

  • Start RL/Oxygen 

  • Give left lateral position

  • Call the resident

  • Stop oxytocin

  • Ask sister to give OT changes/scrubs  


Written by our guest author - Yash Bandewar and Anveshi Nayan

Illustration by Devi Bavishi

#Ae(ONE)INTERN

 

 

 

  


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