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CTG Interpretation and Management

CTG Interpretation and Management. Miss Philippa Moth Locum Consultant Obstetrician and Gynaecologist Maidstone and Tunbridge Wells NHS Trust. NICE Guidelines Definitions and normal limits Acting on abnormal CTGs Common pitfalls. Who Gets Continuous Monitoring?. Maternal. Fetal.

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CTG Interpretation and Management

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  1. CTG Interpretation and Management Miss Philippa Moth Locum Consultant Obstetrician and Gynaecologist Maidstone and Tunbridge Wells NHS Trust

  2. NICE Guidelines • Definitions and normal limits • Acting on abnormal CTGs • Common pitfalls

  3. Who Gets Continuous Monitoring? Maternal Fetal Abnormal intermittent monitoring IUGR Oligo Postdates Multiple Pregnancy Breech Epidural Meconium • Hypertension • IOL / Augmentation • DM • Pyrexia • Previous Caesarean • Patient Request

  4. NICE Guidance

  5. DR C BRAVADO • DR Define Risk • C Contractions • BRA Baseline Rate • V Variability • A Accelerations • D Decelerations • 0 Overall Impression

  6. Accelerations

  7. Decelerations • Early • Variable - Typical - Atypical • Late

  8. Early Decelerations • Due to head compression

  9. Typical Variable Decelerations • Due to cord compression

  10. Atypical Variable Decelerations

  11. Late Decelerations • Due to Fetal Hypoxia

  12. Normal Variability

  13. Reduced Variability

  14. Acting on CTGs • Normal • Suspicions / pathological - review in a set amount of time - FBS - Deliver

  15. Bradycardia

  16. Sinusoidal CTG

  17. Common Pitfalls • Interpretation of CTGs outside of labour • Situations to think carefully about FBS - VBAC - Pyrexia - Intrapartum haemorrhage

  18. Common Pitfalls

  19. Fresh Eyes • Never hesitate to ask for a second opinion

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