Cardiotocography
Cardiotocography (CTG) is a method used to record the fetal heartbeat and uterine contractions during pregnancy, particularly in the third trimester. The device utilized for this monitoring is called a cardiotocograph, commonly known as an electronic fetal monitor. CTG is instrumental in identifying signs of fetal distress. Fetal well-being is often assessed through CTG monitoring, which helps detect infants who may be hypoxic (low in oxygen). The primary use of CTG is during labor. A review of existing research concluded that, although the studies on this topic may be outdated and should be interpreted with caution, there is currently no evidence supporting the idea that continuous monitoring of high-risk pregnant women during the prenatal period (before labor) provides benefits for either the mother or the unborn child.
About Cardiotocography (CTG)
Cardiotocography (CTG) is a visual representation of uterine contractions and fetal heart rate (FHR). Although cardiotocographic monitoring is considered crucial, there is considerable variability in practice and recommendations regarding the duration of monitoring. Continuous monitoring may be necessary for a minimum of six hours and potentially up to twenty-four hours to effectively diagnose conditions such as premature labor and placental abruption. CTG is a widely used tool in labor and delivery for detecting fetal hypoxia. By analyzing the FHR pattern, healthcare providers can assess its baseline, variability, and cyclical variations, noting that fetal heart rate may rise when baseline variation decreases during episodes of fetal hypoxia.
Cardiotocography for Pregnancy
CTG is a medical test conducted during pregnancy to monitor the baby’s heart rate and the mother’s contractions, ensuring the baby’s well-being and early detection of potential issues. During the test, two sensors are placed on the mother’s abdomen: one records the baby’s heartbeat, while the other tracks uterine contractions. The procedure typically lasts about 20 to 40 minutes and is painless.
CTG is particularly important in the later stages of pregnancy or when there are concerns about the baby’s health. It helps doctors understand how well the baby is coping with the stress of contractions and labor. If the heart rate indicates distress, healthcare providers can take appropriate actions to ensure the baby’s safety. Overall, CTG is a valuable tool that offers critical insights into the health of both the mother and baby during pregnancy.
Procedure of Cardiotocography (CTG)
CTG monitoring is widely used to evaluate fetal well-being by identifying infants at risk of hypoxia (lack of oxygen).
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Preparation: The healthcare provider explains the procedure to the expectant mother and ensures her comfort. The woman is positioned comfortably on her back or side, depending on her gestational age and individual comfort.
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Application of Transducers: Two transducers are placed on the woman’s abdomen:
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The ultrasound transducer is positioned over the area where the fetal heart rate is most easily detected.
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The toco transducer is placed over the fundus of the uterus to measure uterine contractions.
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Monitoring: The CTG machine continuously records the fetal heart rate and uterine contractions for a specific duration, typically 20 to 30 minutes. The machine produces a graph (trace) that displays changes in fetal heart rate and uterine contractions over time.
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Interpretation: A healthcare provider analyzes the CTG trace to assess fetal well-being, examining various parameters, including baseline fetal heart rate, variability, accelerations, decelerations, and the relationship between fetal heart rate and contractions.
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Assessment of Variability and Patterns: Variability refers to normal fluctuations in the fetal heart rate, indicating a healthy nervous system. The provider evaluates patterns such as accelerations (temporary increases in heart rate) and decelerations (temporary decreases in heart rate) for normalcy.
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Non-Reactive Traces: If the CTG trace shows no significant variability or abnormal patterns, it is considered non-reactive. In such cases, further assessment or additional tests may be necessary to evaluate fetal well-being more closely.
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Documentation and Communication: The findings from the CTG monitoring are documented in the mother’s medical records, and the results are communicated to her and the healthcare team. Based on the CTG findings, further actions, such as additional testing, changes in management, or further monitoring, may be recommended.