CTG .pptx

How to read CTG

1. Cardiotocography INTERPRETATION OF CTG TRACING OBSTETRIC DEPARTMENT Dr Mona Al- omayri Dr Amal Al- zahrani Senior Resident R5

2. What is cardiotocography? Cardiotocography  (CTG)  is used during pregnancy to monitor the fetal heart and contractions of the uterus. Its purpose to early detection of fetal distress.

3. HOW TO READ A CTG ?

4. Intrapartum care: NICE guideline CG190 (December 2014).

5. Define risk ( the high risk ?) Obstetric complications Multiple gestation Post-date gestation Previous cesarean section Intrauterine growth restriction Premature rupture of membranes Congenital malformations Oxytocin induction /augmentation of labour Pre-eclampsia Maternal medical illness Gestational diabetes Hypertension Asthma Other risk factors Absent of prenatal care Smoking Drug abuse

6. Contractions Dr C Bravado  ALSO

7. Monitoring of Contractions

8. Uterine contractions (CTG) Record the  number  of  contractions  present in a  10   minute   period . Each  big   square  on the CTG chart is  equal   to   one   minute , so look at how many contractions occurred within 10 big squares.

9. Abnormal contraction Tachysystole - > 5 contractions/ 10 min. .

10. Baseline Rate Reassuring 110-160bpm Non-reassuring Tachycardia 161-180 bpm Bradycardia 100-109 bpm Sinusoidal pattern

11. Normal 110-160BPM Tachycardia>160BPM Bradycardia<110BPM

12. SINUSOIDAL 12 A smooth, regular, wave-like pattern Frequency of around 2-5 cycles a minute Stable baseline rate around 120-160bpm No beat to beat variability

13. Variability Reassuring ≥ 5 bpm Non-reassuring < 5 bpm for ≥ 40 min refers to the  variation  of  fetal   heart   rate  from  one   beat   to   the   next

14. 14 REDUCED VARIABILITY

15. Accelerations Transient increase in FHR of 15 bpm or more lasting 15 seconds or more

16. 15 beats 15 seconds

17. Decelerations Transient episodes of slowing of FHR more than 15 bpm for more than 15 seconds Non-reassuring Early Variable Late Prolonged > 3 min

18. EARLY DECELERATIONS 18

19. Early deceleration Head compression

20. LATE DECELERATIONS 20

21. Late deceleration Foetal Hypoxia

22. VARIABLE DECELERATIONS 22

23. Variable decelerations cord compression Foetal hypoxia

24. Abnormal Prolonged Deceleration

25. OVERALL IMPRESSION

26. Normal All 4 reassuring features Suspicious 1 non-reassuring 3 reassuring features Pathological 2 or more non-reassuring or 1 or more abnormal Categorisation of fetal heart rate traces Category Definition Normal All 4 reassuring Suspicious 1 non-reassuring Rest reassuring Pathological 2 or more non-reassuring 1 or more abnormal

27. Thank You ….