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CTG
Foetal Monitoring
| Question | Answer |
|---|---|
| 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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