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CTG

CTG. V.D.P. Steps of external monitoring. Terminology. Baseline Heart Rate ( BHR ) – 110 – 150 bpm Bradycardia – BHR < 110 bpm Mod – 100 – 110 bpm Tachycardia - BHR > 150 bpm Mod – 150 – 170 bpm Acceleration / Deceleration - > 15 bpm for 15 sec. Baseline Variability - 10 – 25 bpms

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CTG

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  1. CTG V.D.P.

  2. Steps of external monitoring

  3. Terminology • Baseline Heart Rate ( BHR ) – 110 – 150 bpm • Bradycardia – BHR < 110 bpm • Mod – 100 – 110 bpm • Tachycardia - BHR > 150 bpm • Mod – 150 – 170 bpm • Acceleration / Deceleration - > 15 bpm for 15 sec. • Baseline Variability - 10 – 25 bpms • Silent - 0 – 5 bpm • Reduced - 5 – 10 bpm • Saltatory - > 25 bpm (Sleep or Quiet phase, Prematurity, Anaemia, Infection, Anaesthetics, Sedatives, Anti hypertensive all ↓ variablity ) V.D.P.

  4. Baseline variability The minor fluctuations in baseline FHR occurring at three to five cycles per minute. It is measured by estimating the difference in beats per minute between the highest peak and lowest trough of fluctuation in a one-minute segment of the trace

  5. DECCELERATIONS • EARLY : Head compression • LATE : U-P Insufficiency • VARIABLE : Cord compression Primary CNS dysfn

  6. EARLY

  7. LATE

  8. VARIABLE

  9. Late deceleration • Late deceleration followed by normal baseline – mild compromise Late deceleration followed by reduced baseline variability and tachycardia – severe compromise V.D.P.

  10. Management • Fetal HR Pattern classification • Normal means fetal health is well • Suspicious means • Continue observation • Additional tests Pathological means • Additional tests • intervention

  11. CLINICAL CTGSCENARIOS V.D.P.

  12. early decelerations • resulting from descent of fetus causing head compression, • returning to normal in between contractions , V.D.P.

  13. variable deceleration • Cause: had cord prolapse, may lost baby before Management: CS V.D.P.

  14. variable deceleration • Cause: had cord prolapse, may lost baby before Management: CS V.D.P.

  15. prolonged bradycardia V.D.P.

  16. prolonged deceleration V.D.P.

  17. reduced base line variability with deceleration and bradychardia V.D.P.

  18. Late deceleration, V.D.P.

  19. Deceleration • hypertonic contraction with bradycardia. V.D.P.

  20. V.D.P.

  21. Normal V.D.P.

  22. SINUSOIDAL PATTERN : • in fetal anemia, Rh, fetal hhage, cordocentesis, . V.D.P.

  23. SINUSOIDAL PATTERN RH –ve, IUGR COOMBS +ve,1:64, 34 weeks LSCS , died after 5 days V.D.P.

  24. PROLONGED BRADYCARDIA Immediate CS V.D.P.

  25. THANK YOU !!! V.D.P.

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