What does the CTG graph shows?
Ans. (A) Deceleration in cardiotopography(Ref: William's Obstetrics 25th Ed; Page No- 335-39)Non-stress Test (NST)This test assesses the frequency of fetal movements using an external fetal heart rate (FHR) monitoring device to detect the presence or absence of accelerations.It is also known as cardiotocography (CTG).These are abrupt increases in FHR above the baseline lasting <2 min and are unrelated to contractions. The criteria vary by gestational age:#<32 weeks, the increase should be >=10 beats/min lasting >=10s#>32 weeks, the increase should be >=15 beats/min lasting >=15sNon-stress Test (NST)Reactive NSTCriteria: > Two accelerations in 20 min: Increases Fetal Heart Rate >15 beats/min (bpm) above baseline (if > 32 weeks GA; >=10 bpm if < 32 weeks GA) lasting for at least 15 seconds.Assessment: Reassuring of fetal well-being (Fetal Heart Rate is monitored externally by Doppler along with a tocodynamometer to detect uterine contractions. Acoustic stimulation may be used in some cases).Follow-up: Repeated it weekly/biweeklyNonreactive NSTCriteria: No Fetal Heart Rate accelerations or did not meet criteria over a 40-minute periodAssessment: Fetal CNS anomalies, fetal Sleeping, maternal sedative or narcotic administrationFollow-up: VASIf still No Response: Perform further tests like:- Contraction Stress Test (CST) or Biophysical profile (BPP)
Deceleration in cardiotopography
Acceleration in cardiotopography
Cannot be said
Normal cardiotopography
Diagnosis in Obstetrics