CTG Monitoring

Cardiotocograph (CTG) OUTLINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Fetal heartbeat Cardio- Uterine contractions -Toco- ,[object Object],+ during childbirth CARDIOTOCOGRAPHY ,[object Object],is a transducer, moveable w/ sensor use to measure contraction frequency & duration

Cardiotocograph ,[object Object],[object Object],[object Object],[object Object],Dr. Orvan Hess

[object Object],[object Object],[object Object]

Method ,[object Object],[object Object],[object Object],Recordings are done by two separate transducers one for the measurement of the fetal pulse a second one for the contractions

External measurement ,[object Object],[object Object],[object Object],[object Object],Hint: Determination intensity of contraction palpate fundus use your fingertips if touch like tip of nose= mild Chin= moderate intensity Pushing on forehead= strong

External Fetal Monitor (EFM) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Internal measurement ,[object Object],[object Object],[object Object],Internal measurement is more precise, and might be preferable when a complicated childbirth is expected .

INTERNAL FETAL MONITOR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Baseline fetal heart rate (FHR) ,[object Object],[object Object],[object Object]

Baseline variability ,[object Object],[object Object],Uterine activity Normal variability is reassuring Sign that fetus nervous system is intact FHR bpm

2 types of Variability ,[object Object],[object Object],[object Object],[object Object],[object Object],Absent - No fluctuation Minimal - 5 bpm or less Moderate/Normal – 5bpm to 25

Accelerations ,[object Object],[object Object],Fetal Rate (FHR) Activity Maternal Uterine Activity

Decelerations ,[object Object],[object Object],[object Object]

Early Deceleration ,[object Object],onset contraction Recovery

Variable Deceleration ,[object Object],Variable onset

Complicated variable decelerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Prolonged decelerations ,[object Object],Identify the features of the FHR trace which have the highest information content

Late decelerations ,[object Object],Onset Recovery

Normal antenatal CTG trace : ,[object Object],[object Object],[object Object],[object Object],[object Object]

Normal intrapartum CTG trace: ,[object Object],[object Object],[object Object],[object Object],[object Object]

Non-reassuring CTG trace ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Abnormal CTG trace is where: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Indications for intrapartum fetal surveillance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Intrapartum risk factors , including: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Equipment ,[object Object],[object Object],[object Object]

Process Preparation ,[object Object],[object Object],[object Object],[object Object],[object Object]

Subjective analysis of FHR traces in labour

Interpretation and documentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Interpretation ,[object Object],[object Object],[object Object],[object Object]

CTG Monitoring

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CTG Monitoring