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CTG analysis is used to detect fetal distress by monitoring the fetal heart rate and uterine contractions. A CTG records the fetal heart rate (cardio) and uterine contractions (toco). A normal CTG will show a fetal heart rate between 110-160 bpm with variability between 5-15 bpm. Abnormal readings include tachycardia over 160 bpm, bradycardia under 110 bpm, and variability under 5 bpm. Decelerations in heart rate associated with contractions are classified as early, late, variable, or prolonged. CTG is an important tool for evaluating fetal wellbeing during pregnancy and labor.

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408 views23 pages

CTG New

CTG analysis is used to detect fetal distress by monitoring the fetal heart rate and uterine contractions. A CTG records the fetal heart rate (cardio) and uterine contractions (toco). A normal CTG will show a fetal heart rate between 110-160 bpm with variability between 5-15 bpm. Abnormal readings include tachycardia over 160 bpm, bradycardia under 110 bpm, and variability under 5 bpm. Decelerations in heart rate associated with contractions are classified as early, late, variable, or prolonged. CTG is an important tool for evaluating fetal wellbeing during pregnancy and labor.

Uploaded by

Lola Putri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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CTG ANALYSIS IN FETAL

DISTRESS DETECTION

Leni Widiawati
4151121510

INTRODUCTION

1 in 1,146 pregnancies
(0.07%).

initial signs and symptoms


of uterine rupture are
typically nonspecific

difficult to diagnose
and delays the
definitive therapy


LITERATURE REVIEW

DEFINITION

The CTG monitor records both fetal heart rate


(cardio) and maternal uterine contractions
(toco). cardiotocograph (CTG) is an invaluable
tool in the monitoring of fetal well-being.

INDICATIONS
Uterine Status

Unscarred
Scarred

Uterine
Configuration

Normal

Congenita
l uterine
anomaly

Pregnancy
Considerations

Grand multiparity
Maternal age
Placentation
(accreta, percreta,
increta, previa,
abruption)
Cornual (or angular)
pregnancy
Uterine
overdistension
(multiple gestation,
polyhydramnios)
Dystocia(fetalmacro
somia, contracted
pelvis)
Gestation longer
than 40 weeks
Trophoblastic
invasion of the
myometrium
(hydatidiform mole,
choriocarcinoma)

CONDITIONS OF CTG
EXAMINATION

Gestational week 28 week


Inform consent
Maximum FHR is known
Correct procedure

CHARACTERISTICS OF THE CTG

CTG examination can be classified into two


major parts, which are:
1. The basic fetal heart rate (baseline fetal
heart rate). including the fundamental
frequency and FHR variability.
2. Changes in the periodic / episodic FHR.
(Periodic changes in FHR are caused by
contractions of the uterus; while episodic
changes are not caused by uterine
contractions, for example fetal movement and
reflexes cord)

FHR BASIC FREQUENCY


(1)

Under normal circumstances, the fundamental


frequency of FHR ranges between 120 160
bpm (this opinion adopted in Indonesia). There
also are some who are pointing the normal
range in 115-160 bpm or110 - 160 bpm.
Fundamental FHR frequency over 160 bpm
called tachycardia
when less than 120 bpm is called bradycardia.

FHR BASIC FREQUENCY


(2)
Maternal
Fetal hypoxia or anoxia
Fetal acidosis
(umbilical artery cord
pH < 7)
Depressed apgar
scores (five minute
apgar score < 7)
Admission to neonatal
intensive care unit
Fetal or neonatal death

Fetal

Severe blood loss,


anemia, or need for
transfusion
Hypovolemic shock
Maternal bladder injury
Cystotomy
Need for hysterectomy
Death

FHR VARIABILITY

Irregular oscillations on the recording FHR caused by the


balance of the sympathetic nervous system (cardioaccelerator)
and parasympathetic (cardiodecelerator)
The scoring of FHR variability is by measuring the amplitude of
variability (long term variability). Based on the magnitude of the
amplitude, FHR variability can be categorized as follows:
1. Normal variability: the amplitude range between 5-15 bpm.
2.Reduced variability: the amplitude 2-5 bpm.
3.Disappeared variability: the amplitude of less than 2 bpm.
4.Excessive variability: amplitude of more than 15 bpm.

Normal FHR
Variability

Acceleration
(Excessive Variability)

.Accelerations defined as an increase in FHR >15 bpm for


more than 15 seconds When accelerations are present, the
CTG is said to be reactive. Accelerations are often associated
with fetal activity and are considered an indication that the
fetus is healthy

Decelerations
(Reduced Variability)

Decelerations are usually associated with uterine


contractions. They can be subdivided into four main
types by their shape and timing in relation to
uterine contractions. Uterine contractions must be
monitored adequately in order for a deceleration to
be correctly classified. Decelerations may be:
Early
Late
Variable
Prolonged

Early decelerations

Late decelerations

Variable
decelerations

Prolonged
decelerations

CTG CATEGORIZATION

CONTRAINDICATION OF
CTG

Until recently, it has not been found yet the


contraindication of CTG examination toward
both mother and fetus


DISCUSSION

CTG is able to monitor whether fetal heart is


normal or abnormal (fetal distress). The
characteristics of CTG to show normal fetal heart
rate are: (1) FHR baseline normal range of 110
160 bpm, and (2) FHR variability is between 5-15
bpm while the characteristics of abnormal fetal
heart include Fetal tachycardia with FHR baseline
rate of >160 bpm and the FHR variability is >15
bpm and Fetal bradycardia with a FHR baseline rate
of <110 bpm and FHR variability is <5 bpm.

Summary

cardiotocography is functioning as an evaluator of fetal


conditions by recording the fetal heart rate patterns
and to monitor the effects of uterine contractions. Or it
can be said that cardiotocography is an electronic
instrument designed to detect the fetal heart rate
simultaneously and measure the intensity and duration
of uterine contractions

THANK YOU

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