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CTG Interpretation and Management. Miss Philippa Moth Locum Consultant Obstetrician and Gynaecologist Maidstone and Tunbridge Wells NHS Trust. NICE Guidelines Definitions and normal limits Acting on abnormal CTGs Common pitfalls. Who Gets Continuous Monitoring?. Maternal. Fetal.
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CTG Interpretation and Management Miss Philippa Moth Locum Consultant Obstetrician and Gynaecologist Maidstone and Tunbridge Wells NHS Trust
NICE Guidelines • Definitions and normal limits • Acting on abnormal CTGs • Common pitfalls
Who Gets Continuous Monitoring? Maternal Fetal Abnormal intermittent monitoring IUGR Oligo Postdates Multiple Pregnancy Breech Epidural Meconium • Hypertension • IOL / Augmentation • DM • Pyrexia • Previous Caesarean • Patient Request
DR C BRAVADO • DR Define Risk • C Contractions • BRA Baseline Rate • V Variability • A Accelerations • D Decelerations • 0 Overall Impression
Decelerations • Early • Variable - Typical - Atypical • Late
Early Decelerations • Due to head compression
Typical Variable Decelerations • Due to cord compression
Late Decelerations • Due to Fetal Hypoxia
Acting on CTGs • Normal • Suspicions / pathological - review in a set amount of time - FBS - Deliver
Common Pitfalls • Interpretation of CTGs outside of labour • Situations to think carefully about FBS - VBAC - Pyrexia - Intrapartum haemorrhage
Fresh Eyes • Never hesitate to ask for a second opinion