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CTG

Foetal Monitoring

QuestionAnswer
What is the normal FHR? 110-160 bpm
What is normal variability? 5 to 15 bpm above AND below baseline
What is an acceleration? FHR greater than 15 bpm from baseline for at least 15 seconds
What is a deceleration? FHR less than 15 bpm from baseline for at least 15 seconds
Abnormalities of FHR Tachycardia, bradycardia
Abnormalities of variability Minimal or marked
Abnormalities of decelerations Late and Variable, and prolonged
Causes of foetal tachycardia Hypoxia, chorioamnionitis, hyperthyroidism, foetal or maternal anaemia, tachyarrhythmia
Causes of foetal bradycardia Mild: Post dates, OP or transverse positions Severe: prolonged cord compression, cord prolapse, epidural/spinal anaesthesia, maternal seizures, rapid descent
Causes of decreased variability Foetal sleeping (no longer than 40 mins), Acidosis due to hypoxia, tachycardia, drugs such as opiates, prematurity, congenital heart anomalies
Cause of early decelerations Uterine Contractions stimulating vagal response on foetal head. Normal
Cause of late decelerations Hypoxia due to placental insufficiency (maternal hypotension, pre-eclampsia, uterine hyperstimulation)
cause of variable decelerations cord compression, usually of umbilical vein
what is prolonged deceleration deceleration lasting more than 2 mins
cause of sinusoidal pattern severe foetal hypoxia, severe foetal haemorrhage, severe foetal anaemia
What is a reassuring CTG Baseline FHR 110-160, normal baseline variability, 2 or more accelerations in 20 mins
What is a non-reassuring CTG? Abnormal FHR, variability, late / variable decelerations
How would you as an intern manage a pt with a non-reassuring CTG? 1. Call for help 2. Place in LLP 3. Oxygenate mother 4. Give IV fluids 5. Stop any induction infusion
How would the team manage a pt with a non-reassuring CTG? 1. Informed consent for C/section 2. Inform anaesthetist and neonatologist 3. Empty maternal bladder with ucath 4. Perform blood investigations: CBC, UE, GXM with reservation of blood 5. Porters for transfer
causes of increased variability Foetal stimulation, temporary hypoxia, sympathomimetic drugs
causes of prolonged deceleration amniotic fluid embolus, maternal hypotension, cord compression, tetanic uterine contractions
what is uterine hyperstimulation exaggerated uterine response with late decelerations
what is uterine tachysystole greater than 5 contractions in 10 mins
uterine hypertonicity? contractions lasting more than 90 s
Created by: IonaDel
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