Obstetric Monitoring

 

CTG:

Normal variability

·      6-25bpm

Reduced variability

·      3-5bpm

Absent variability

·      <3

Acceleration

·      Increase >15bpm for 15 sec

·      (Occurs with head compression)

Deceleration

·      Decrease >15bpm for 15 sec

Early decel

·      Benign

·      Baby sleeping

·      Usually when cervix mid-dilated 4-8cm

(Benign) variable decel

·      Brief

·      Asssociated with contraction

·      If CTG otherwise good

Complicated variable decel

·      Too big amplitude

·      Too long

·      Rising baseline

·      Reduced variability

·      Reduced post-deceleration shouldering

Late decel

·      Nadir >20sec after peak of contraction

·      Ends after the contraction

·      Important even if amplitude is very small

·      = hypoxia

Prolonged decel

·      90sec – 5mins

Post-deceleration shouldering

·      Transient overshoot of heart rate after the deceleration

Sinusoidal

·      Smooth regular oscillation

·      2-5 times per minute

·      5-15bpm amplitude

·      = severe foetal anaemia (Hb <50)

Pseudosinusoidal

·      Not smooth or regular

·      = nothing

 

Apgar score:

 

0

1

2

Appearance

(Colour)

Blue

In between

Pink

Pulse

(heart rate)

0

0-100

>100

Grimace

(Response to stimulation)

No response

Some response

Proper response

Activity

(Limb movement)

Floppy

Flexed

Moving

Respiratory rate

Nothing

Slow and irregular

Crying ++

 

 

Scoring:

Bad 0-3

Moderate 4-6

Good 7-10

 

Target Preductal sats:

·         1 minute: 60-65%

·         5 minutes: 80-85%

 

 

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