MUTHU- CTG INTERPRETATION

By siddharthabhimanyu52 | Updated: Aug. 5, 2020, 8:36 a.m.

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CTG Interpretation

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Hey there!
I am Dr. Christian Bravado.
Are you the new senior clerk?
Do you know how to interpret a CTG?
Lets review.
Its simple..
Just remember my name.
" DR. C BRaVADO"
DR: Define Risk
C: Contractions
BRa: Baseline Rate
V: Variability
O: Overall Impression
D: Deceleration
A: Acceleration
Lets interpret this sample CTG
Fetal Heart Monitor
Uterine Contractions
Paper speed: 1cm/min
1 cm= 2 small squares
Define RISK
Assess if its a High or Low risk pregnancy.
HIGH RISK PREGNANCIES 
Overt/ Gestational Diabetes Mellitus

Hypertensive Disorders
Bronchial Asthma
Maternal Hematologic disorders
Multifetal Gestation
Postterm Pregnancy
Scarred Uterus
IUGR/PROM
Augmentation/ Induction of Labor
Maternal Smoking or Drug abuse
10 Minute block
Contractions
Check the number of contractions in 10 minutes.
Here, there are 6 uterine contractions in 10 minutes.
Next, add the intensity of all the contractions.
Intensity of a single contraction= Peak - baseline.
Here the total intensity of uterine contraction is 
6 * ( 100-0) =  600 Montevideo Units (MVU)
Baseline Rate
10 Minute block
Average heart rate of the fetus within a 10-minute window.
BRADYCARDIA: <110 bpm
NORMAL BASELINE FHT: 110-160 bpm
TACHYCARDIA: >160 bpm
Here, the baseline FHT is 190bpm.
The fetus is in tachycardia.
Variability
Refers to the variation of fetal heart rate from one beat to the next.
Most consistent indicator of fetal wellbeing  at that particular moment in time.
Absent- undetectable amplitude; 
Minimal- <5 beats deviation from baseline.
Moderate-  5-25 beats deviation [ CONSIDERED NORMAL]
Marked- >25 beats deviation
Here, the variability is minimal.
Acceleration
Abrupt increase of at least 15bpm in fetal heart rate above baseline for >/=15 seconds
Presence of acceleration is reassuring.
It's absence with otherwise normal CTG is of uncertain significance.
No accelerations are seen here.
Deceleration
Decrease in baseline heart rate of >15 bpm for >15 seconds.
TYPES:
Early: Deceleration starts with uterine contraction and recovers when the contraction stops. Physiological. D/t inc. fetal ICP and inc. vagal response
Variable: Abrupt deceleration. No relationship with the uterine contractions. D/t Umbilical cord compression. Have " Shoulders". Seen usually during Labor and patients with oligohydramios.
Late: Onset begins at the peak of uterine contraction. D/t Insufficient blood flow through uterus and placenta. Indicates Fetal hypoxia and acidosis.
Prolonged: deceleration lasting >/= 2 mins but <10 minutes.
1 Early decelration 
is seen here.
OVERALL IMPRESSION
OUR CTG FINDINGS
190 bpm; Tachycardia
Reduced Variability (Minimal)
An Early Deceleration was seen
Impression:
Category 2 Suspicious
Wasn't that simple?
Now its your turn.
REMEMBER:

" DR. C  BRaVADO"
Define risk: History not available
10 Minute block
There are 4 contractions in 10 minutes.
Contractions
Baseline Contraction is 5 MVU.
TOTAL MVU= (95-5)+ (100-5)+ (80-5)+ ( 90-5)
=  90+ 95+ 75+85
=  345 MVU
Baseline Rate
Baseline Fetal Heart rate is 170bpm
Fetus is in tachycardia.
Variability
Here the variability is absent.
Acceleration
No acceleration seen here.
Decelerations
Multiple, repetitive late decelerations are seen.
Complete CTG Interpretation
DR- Define Risk: 
C- Contraction:
BRa- Basaline Rate:
V- Variability:
A- Accelerations:
D- Decelerations :
O- Overall Impression:
170bpm
4 contractions in 10 minutes; 345 MVU
N/A
Absent
None
Multiple, repetitive late decelerations
Category 3: Abnormal/ Pathological
Nicely done!!
Until next time!!

MUTHU- CTG INTERPRETATION

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