Cardiotocography
- a method of fetal monitoring using the simultaneous monitoring of the fetal heart rate (cardiotachogram) and uterine contractions (tocogram) conducted on a two-curve electronic recording
- it is also possible to record and register fetal movements and the mother's heart rate
- we evaluate the contraction activity of the uterus and the fetal heart rate
- it helps to diagnose fetal hypoxia and reduces the incidence of metabolic acidosis
- used to monitor the heart rate of the fetus
- expresses time and frequency values, heart rate values and acoustic recording, thanks to which we are able to detect fetal arrhythmias
- a graphic representation of uterine smooth muscle activity (myometrium), expressed in kPa, is recorded in the lower part of the CTG record
Tocogram
Uterine activity is usually detected by an external pressure sensor, which responds to changes in the tension of the abdominal wall during contraction
Weevaluate:
the basal tone of the uterus, the frequency and length of the contraction cycle, length of the inter-contraction period, the amplitude of the contractions, the duration of the contraction and its form
Device operation
- We fasten the external probes to the mother's abdomen using elastic bands
Device operation
- We place the external sensor at the place of the best capture of the fetal heart rate determined by its lie and position.
- We apply a sufficient amount of sonographic gel to the contact surface of the probe and apply it to the place where the echos are most audible
- By turning on the cardiotocopraph device = pressing the start button, the recording will start and the CTG curve will be created
- The most suitable position for CTG monitoring is lying down (on the left of right side) or sitting
- We end the recording with the stop button and paper shift button
We record for MINIMUM of 20 minutes
Basic evaluation of the physiological curve
- Basal frequency 110 – 160 bpm
- Variability 5 – 25 bpm
- Absence of decelerations or presence of early decelerations
Care of the midwife during the evaluation of a suspicious or pathological record
Necessary measures:
- initiate measures to improve oxygenation of the fetus – position of the mother on her left side
- give oxygen
- discontinue oxytocin infusion
- administration of intravenous fluids
