C ardio- T oco- G raph

1. C ardio- T oco- G raph Screening tool to assess the fetal state of oxygenation and predicts early signs of hypoxia and fetal distress.

2. Cardiotocography Components • Stimulus: Contractions/ fetal movements • Baseline fetal heart rate • Baseline variability • Accelerations • Decelerations

4. Cardiotocography How to read a CTG • baseline heart rate

5. Cardiotocography How to read a CTG • Baseline variability • Classification: • Silent 0-5 bpm • Reduced 6-10 bpm • Normal 11-25 bpm • Saltatory >25 bpm

6. Cardiotocography • accelerations

7. Cardiotocography • Deceler ations:

8. Decelerations Types:

9. Basal fetal oxygenation. The relationship of late decelerations to baseline fetal oxygenation during contractions

10. Contraction Stress Test

11. How to Read CTG Patient's data + Date & Time DR C BRAVADO Signature + Date & Time

12. How to Read CTG DR C BRAVADO VARIABILITY ACCELERAT’N DECELERAT’N CONTRACTIONS DEFINE RISK BASELINE RATE OVER ALL ASSESSMENT

13. classification of Fetal Heart Rate Pattern Normal Pattern • Baseline Rate 110-150 bpm • Amplitude of baseline variability 5/10-25 bpm • Absence of decelerations, except for fleeting& short • Presence of 2 or more accelerations during a 20 min period

14. classification of Fetal Heart Rate Pattern Suspicious pattern • Baseline rate of 150-170 bpm/ 100-110 bpm • Amplitude of variability bn 5-10 bpm > 40 min • Increased variability above 25 bpm {saltatory} • Absence of accelerations for > 40 min • Sporadic decelerations of any type, unless severe

15. classification of Fetal Heart Rate Pattern Any of the following: Pathological Pattern • Baseline heart rate < 100 bpm or > 170 bpm • Variability < 5 bpm for > 40 min • Recurrent decelerations of any type • Severe variable or late decelerations • A sinusoidal pattern