How is the CTG procedure of the baby's heart performed? Deciphering the CTG of the fetus. Principles of recording CTG

03.07.2019

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Why do CTG during pregnancy and what shows what is the norm. A cardiotocography study (CTG) is an assessment of the condition of the fetus based on the work of the baby's heart and uterine contractions in pregnant women. Research before and during childbirth will help to detect a threat to the life of an unborn child and avoid complications.

During pregnancy, a woman, in order to give birth to a healthy child, is simply obliged to undergo many different examinations. These are blood and urine tests, ultrasound methods of examination, consultations of medical workers of various specialties (cardiologist, endocrinologist, etc.). However, not all expectant mothers are aware of such a necessary examination method as cardiotocography, or simply CTG. This method of diagnosis is carried out only during pregnancy.

During the examination, the gynecologist listens to the fetal heartbeat, using a special stethoscope, placing it on the pregnant woman's stomach. After this listening procedure, the gynecologist draws conclusions whether the child's cardiovascular system is working correctly or not. However the use of a stethoscope does not give a sufficiently clear and clear picture of the fetus.

But cardiotocography will give a specific description of the work of the baby's cardiac system, its motor activity, uterine contractions and the baby's reaction to these contractions.

We study the apparatus for cardiotocography

The device with which cardiotocography is done has two sensors and a recording device. The first sensor captures the data of the baby's cardiac activity, and the second sensor captures the tone of the uterus and the reaction of the fetus to uterine contractions.

These sensors are attached to the tummy of a pregnant woman, who holds a special remote control in her hands, which she presses with every movement of the baby. This is how changes in the heart rate are noted during the motor activity of the child. And the results of cardiotocography are recorded on paper in the form of a tortuous line, similar to an electrocardiogram. These data (scores) are later evaluated by the doctor.

When do CTG pregnant

Already with 28th week of pregnancy approved for cardiotocography. However, data collected after the 32nd week will be better and more reliable. This is due to the fact that it is at this moment (at 32 weeks) that the formation of the child's nerve and muscle impulses occurs and the cyclicity of the periods of activity and rest of the baby is formed.

In addition, cardiotocography is carried out during childbirth, to monitor the state of the baby's cardiac activity.

In case of problematic childbirth, when stimulation of labor is needed, cardiotocography is done more often. In such cases, CTG can show whether there is a result from the use of medications that speed up labor, and what is the baby's reaction to uterine contractions. Thanks to cardiotocography, the doctor has information about the condition of the fetus and can adjust the dosage of medications.

A study from 25 weeks of pregnancy is most often performed in case of complications, multiple pregnancy or when a woman does not feel the baby's movement well.

Indications for CTG:

fetal malnutrition or slow fetal growth,
fetal heart defects
diabetes,
hypertension,
multiple pregnancy,
suspicion of preeclampsia or preeclampsia,
absence of baby movements,
vaginal bleeding,
abdominal trauma.

Preparation for cardiotocography

For cardiotocography, no specific preparation is required. However, the inspection lasts quite a long time (40-60 minutes), and, therefore, in order not to languish, you can take a book or magazine with you. A special diet is not required, it is necessary that the pregnant woman is neither hungry nor with a full stomach, because. this will affect the motor activity of the child. Before cardiotocography, it is necessary to visit the bathroom in order to avoid discomfort during the procedure. The procedure is carried out lying on its side.

Test results, KTG norm

The study allows you to assess the health status of the child. Based on the graph obtained after the procedure, the doctor can evaluate the work of the child's heart, determine the level of oxygenation of the child's body. The study enables the doctor to respond quickly and appropriately in the event of a threat to the child's life. In the event of severe intrauterine hypoxia or intrauterine infection, the doctor may decide to immediately perform a caesarean section.

After fixing the cardiotocography data, the specialist doctor proceeds to analyze the data according to certain criteria, estimated from 0 to 2 points. The summed points are announced to the expectant mother.

Results of 9-12 points indicate the good health of the child. And this pregnancy has no abnormalities and should be monitored in the usual way.
Results of 6-8 points describe a slight fetal hypoxia (oxygen starvation). Therefore, for the veracity of the results, it is very important to conduct another examination in a day.
Results of 5 points and below indicate a significant oxygen starvation of the fetus. In such cases, the pregnant woman should be treated or have a caesarean section.

With cardiotocography, the fetal heart rate is calculated in parallel, which is normally equal to 110-160 beats per minute at rest and 130-190 when the fetus moves. But sometimes the sensors cannot set the frequency for various reasons - inaccurate position of the pregnant woman during the study, poor fit of the sensor to the stomach, etc. Then in the results of the inspection it can be written that the aspects are not met. If this happens, then cardiotocography must be done a second time.

Other reasons affecting the results of CTG analyzes:

hypertension,
fever,
placental insufficiency,
sleeping child during examination.

How often do you need to do cardiotocography

Cardiotocography is a harmless process and does not harm the child's body. It is also painless for a pregnant woman (do not give injections, etc.). Taking into account these data, there are no contraindications to CTG. However, it must be taken into account that for accurate execution, the baby must be awake. During sleep, the data will not be reliable.

Cardiotocography is considered an integral method of studying during pregnancy and is carried out in the antenatal clinic and maternity hospitals for free.

Cardiotocography is an important component of a comprehensive assessment of the fetal condition along with ultrasound and doplometry. With the help of this procedure, doctors record uterine contractions and the heartbeat of a baby that has not yet been born. CTG allows you to identify any problems and start solving them in a timely manner.

Doctors who monitor the development of the fetus give women referrals for cardiotocography from the 30th week, but they can be issued earlier if there are certain indications for CTG during pregnancy.

Usually, the fair sex is advised to undergo CTG during pregnancy several times, namely during the third trimester 2 times. If the pregnancy is accompanied by complications, then medical professionals may prescribe an additional study.

CTG is also performed during childbirth. This is required in order to determine the general condition of the crumbs and decide on the further conduct of the birth process. Special control is required for babies who, according to the results of ultrasound, have been identified.

How is CTG done during pregnancy?

Cardiotocography is a safe procedure. It will not harm either the mother or the child.

The question of how CTG is done during pregnancy is of interest to women who have never undergone this procedure. She is absolutely fearless. The doctor asks the woman to take a supine or semi-lying position. You just need to relax and sit comfortably on your back. Several sensors will be attached to the tummy:

Ultrasonic, recording the baby's heartbeat;
Strain gauge (pressure sensor), with the help of which uterine contractions are recorded.

Cardiotocography is carried out in a phase that is characterized by fetal activity. The doctor makes an appointment within 30-60 minutes. All data in the form of graphs is recorded by a special apparatus on a paper tape.

A woman should not forget preparation for CTG during pregnancy. It is recommended to sleep well before the procedure, tune in, forget about all the problems and fears and have a snack before it.

You can eat a chocolate bar before cardiotocography so that the child does not sleep, but is more active. Before starting the study, you should definitely go to the toilet, as the procedure takes a long time.

Deciphering CTG during pregnancy

The doctor can show the results of CTG during pregnancy on a paper tape, which shows graphs-curves, or say by naming the number of points scored.

Deciphering CTG during pregnancy is not an easy task. Well, if the graphs do not cause absolutely no suspicion. Then the doctor and the expectant mother will not have to worry about anything. However, in life there are different cases. The results of CTG can be alarming. In such a situation, it is very important not to make a mistake. Any decision should be carefully thought out by the doctor, because every action and word affects the child.

Here is a vivid example taken from life: a young doctor, who had not yet gained experience, did not like the results of cardiotocography of one patient. He told the pregnant woman about his concerns, but she categorically did not believe the results of fetal CTG during pregnancy. One can easily imagine how the woman felt at that moment.

The specialist called an ambulance, as he was worried about the patient's condition and the life of the fetus. In the maternity hospital in the pathology department, it later turned out that the pregnant woman had absolutely no abnormalities. With what mood will this patient come to the antenatal clinic next time?

It would be nice if the expectant mother would learn to interpret the results of cardiotocography in general terms. So it would be possible to avoid unnecessary waste of nerves and a collision with the above incident.

When deciphering cardiotocography and making a diagnosis, many factors must be taken into account, because the results are influenced by weather conditions, the mood of a pregnant woman, sleep or active wakefulness of children. Based on the results of poor CTG during pregnancy, it is not recommended to draw conclusions about the condition of the child in the tummy, because even an absolutely healthy baby may have “suspicious” graphics.

When deciphering a cardiotocogram, doctors take into account several basic parameters: basal rhythm, amplitude, as well as the frequency of deviations from it, slowing down and increasing heart rate. Each parameter is assigned 0-2 points.

At the final stage, the points obtained are added up, and the condition of the fetus is assessed by their sum:

8-10 points- the norm of CTG during pregnancy;
6-7 points indicate the possible presence of initial signs of fetal distress. The doctor may prescribe an additional study;
5 points or less are an indication that a pregnant woman urgently needs hospitalization and care.

Heart rate assessment

The basal fetal heart rate should be 110-160 beats per minute. The graph clearly shows that ups and downs alternate. However, the doctor is not interested in the minimum or maximum values. It evaluates the mean.

A woman can independently evaluate what CTG shows during pregnancy. To do this, you need to move the printout to arm's length and drag your finger over the graph, as if drawing it in the form of a straight line. The level to which the line on the vertical axis will correspond will be the basal rhythm.

The study of cloves and teeth

The next parameter that doctors evaluate is the variability of the child's heart contractions. Having determined the basal rhythm, you can begin to study the frequency and amplitude of deviations from this rhythm.

The graph clearly shows that the curves have many small teeth and several large teeth. Small teeth show deviations from the basal rhythm. It is desirable that there be no more than 6 pieces per minute - this is the norm of CTG at 32-39 weeks of pregnancy. However, counting the number of small cloves is not so simple. Doctors often estimate the amplitude of deviations - changes in the height of the teeth on average, which should normally be 11-25 beats per minute.

Doctors may not like it if the change in the height of the teeth is 0-10 beats per minute. However, this can be quite normal if the baby feels comfortable in the mother's tummy and sleeps, or the gestation period does not exceed 28 weeks. When the estimated figure of 25 beats per minute is exceeded, medical workers begin to suspect the presence of cord entanglement or.

Evaluation of accelerations and slowdowns

When evaluating increases and decreases in CTG at 32-38 weeks of pregnancy, you should pay attention to the large teeth shown in the graph. Doctors, doing cardiotocography on old devices, ask pregnant women to press a special button when the baby moves. Modern models no longer require this. They themselves are able to register the activity of the fetus. When a baby pushes, his heart beats faster for a few seconds. On the graph, this will be represented as a large tooth growing upwards. This is called accelerating. If there are at least 2 of them on the chart in a 10-minute period, then this will be considered a good sign.

increases may or may not be detected during the study. Do not panic because of this ahead of time. Maybe the baby hasn't woken up yet.

reductions - this is the complete opposite of acceleration. On the CTG chart for 35-39 weeks of pregnancy, they look like teeth growing down. There is no cause for concern if the acceleration on the graph is followed by a short and shallow decrease, after which the curve returns to the basal rate level. High-amplitude reductions can alert. However, before drawing a conclusion, you should pay attention to the 2nd graph, which is available on the printout. Contractions of the uterus, which are noted on it, can affect the occurrence of contractions.

In conclusion, it should be noted that the CTG method has several undeniable advantages. Firstly, thanks to this procedure, you can learn about the condition of the fetus and the nature of labor, quickly identify existing problems and find ways to solve them, and secondly, when CTG is done during pregnancy, there are no unpleasant sensations. The procedure is completely safe for mother and fetus. Thus, if expectant mothers are concerned about the question of whether CTG is harmful during pregnancy, then the answer is always unambiguous - it is harmless.

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Absolutely every woman during pregnancy worries about how her child develops, whether everything is in order. Today, there are methods that allow you to fairly reliably assess the condition of the fetus. One of these methods is cardiotocography (CTG), which reveals the relationship between fetal movements and heart rate. From this article you will learn what CTG is, by what characteristics it is evaluated, what indicators for are the norm, and what affects the results of the study.

What is CTG

Cardiotocography is based on recording the frequency and its changes depending on the influence of external stimuli or fetal activity.

Diagnosis is carried out using two ultrasonic sensors, one of which is fixed on the belly of a pregnant woman, having previously determined the area of good audibility of the child's heartbeat.

It is designed to record the heart activity of the fetus. The sensor perceives the ultrasonic signal reflected from the child's heart, which is further converted by the electronic system into an instantaneous heart rate. The second sensor is fixed on the abdomen in the fundus of the uterus. It registers uterine contractions. To improve the passage of ultrasonic waves, the sensors are treated with a special gel. Also, modern devices are equipped with a remote control, by pressing the button of which, a pregnant woman can note the movements of the fetus.

The results are displayed by the device on a paper tape in the form of a graph. It also displays uterine contractions and fetal movements. According to the data obtained, it is possible to judge, first of all, the state of the nervous system of the baby, his protective and adaptive reactions. If the indicators of fetal CTG are the norm, then the baby feels comfortable, and his development is proceeding according to the timing.

Why is CTG needed?

Examination of a pregnant woman in the office of an obstetrician-gynecologist includes listening to the baby's heartbeat with a stethoscope. A deviation from up or down indicates that the child is experiencing discomfort. In this case, the doctor sends the expectant mother for a more thorough study of the functioning of the fetal cardiovascular system - CTG.

There is a clear relationship between the well-being of a pregnant woman and the condition of the fetus. So, if the pregnancy proceeded calmly, without intrauterine infection, the threat of interruption, preeclampsia, then the results of CTG are likely to be normal. If, with good health of the pregnant woman, suspicious results of CTG are observed, then it is necessary to re-examine after a week.

If serious changes in the state of health are found in a pregnant woman, then it is necessary to conduct CTG as often as possible in order to prevent the occurrence of pathologies in time and take the necessary measures.

Features of the study

CTG is usually prescribed after the 32nd week of pregnancy, since only by this time does the maturation of neuromuscular impulses occur, and the method becomes the most informative.

For example, for fetal CTG, the norm is 33 weeks - the presence of more than two accelerations on the chart. By this time, they are caused by the response of the nervous system to the movements of the fetus or to external factors. At earlier periods, acceleration may be associated with the conditions of intrauterine existence of the fetus, so the study may lead to false results.

Also by this time, the fetus has a cycle of activity and rest, which is of great importance for this study. When conducting CTG during the rest period of the fetus, the results will always be positive, even if there is actually a high degree of hypoxia. That is why the study should be carried out for at least 40 minutes. During this time, the fetus will definitely increase motor activity, which will allow you to register a change in heart rate during its movement.

It is very important that the woman feels calm and comfortable during the examination. Uncomfortable position or strong emotions can cause more active movement of the fetus, which will lead to false results. Usually, during the procedure, the woman sits in a comfortable chair or lies on the couch on her side.

In order to understand how to decipher the CTG of the fetus, we will analyze in detail by what parameters it is evaluated.

Basal heart rate

Basal heart rate is the average fetal heart rate calculated over 10-20 minutes. It is determined in the absence of fetal movement between uterine contractions without external stimuli, without taking into account accelerations and decelerations.

When conducting fetal CTG, the BHR rate is 110-160 beats per minute. Tachycardia, that is, an excess of the normal basal heart rate, can be observed with anemia, malformations and insufficiency of fetal heart function, as well as with a feverish state of a pregnant woman, the presence of an intrauterine infection, and increased thyroid function. Taking drugs that have a cardiac stimulating effect can lead to an increase in the fetal heart rate.

A decrease in the basal level below normal (bradycardia) may be due to hypoxia, fetal heart defects, as well as low maternal blood pressure, hypoxemia, prolonged umbilical cord compression, and the presence of a cytomegalovirus infection in a pregnant woman.

Heart rate variability

This parameter is characterized by the presence of instantaneous oscillations - deviations of heart rate from the basal level. When analyzing CTG, the amplitude of instantaneous oscillations is usually studied, according to the nature of which low oscillations are distinguished (deviation is less than three beats / min), medium (3-6 beats / min), high (amplitude more than 6 beats / min).

For fetal CTG, the norm is 36 weeks - high oscillations, indicating good health of the fetus. The presence of low oscillations indicates pathologies in its development.

Particular attention in the analysis of cardiotocograms is paid to slow oscillations. Depending on their amplitude, a monotonous type is distinguished, which is characterized by a low amplitude of oscillations (from 0 to 5 beats / min), a transitional type with an amplitude of 6 to 10 beats / min, a wavy type (from 11 to 25 beats / min) and a jumping type. (amplitude above 25 beats / min). An increase in the amplitude of oscillations may be associated with moderate hypoxia of the fetus, as well as with the influence of external stimuli that stimulate its nervous system. A decrease in the amplitude of oscillations can be caused by severe hypoxia, which leads to inhibition of the function of the fetal nervous system, by the use of narcotic drugs, tranquilizers.

Accelerations

Acceleration is a temporary increase in heart rate of at least 15 beats / min compared to the basal level and a duration of more than 15 seconds. On a cardiotocogram, they look like tall teeth. Accelerations are a response to external stimuli, uterine contractions, and baby movements. Their presence on the CTG of the fetus is the norm.

Decelerations

Deceleration is a decrease in the fetal heart rate by at least 15 beats / min for more than 15 seconds. The graph is presented as significant depressions. There are early, late and variable decelerations. In addition, they are classified by amplitude as light with a decrease in heart rate up to 30 beats / min, moderate - 30 - 45 beats / min, and severe - from 45 beats / min. A decrease in heart rate may occur due to impaired placental blood flow, squeezing the umbilical cord.

Fetal CTG. Norm of indicators

To assess the condition of the fetus, the World Health Organization has developed recommendations that indicate the minimum and maximum allowable values for each of the parameters. According to these recommendations, fetal CTG (normal for 33 weeks) should have the following values:

Basal heart rate: 110-160 bpm.
Heart rate variability within 5-25 beats / min.
Two or more accelerations within 10 minutes.
No deep decelerations.

It is worth noting that for fetal CTG, the norm of 35 weeks or more is the same as at 33 weeks.

Assessment of the state of the fetus by points

Decipher the results of CTG on a 10-point system, evaluating each criterion from 0 to 2 points. For CTG of the fetus, the norm of 36 weeks, as well as during the entire third trimester, is 9-10 points, if the total number of points is from 6 to 8, this indicates oxygen starvation (hypoxia) without emergency threats, it is necessary to repeat the CTG procedure in a week;

if 5 points or less - it means that the child is experiencing severe oxygen starvation, which can lead to serious neurological problems, urgent action is needed.

It must be remembered that even if the CTG of the fetus is 8 points or slightly lower, there is no need to be scared ahead of time. In this type of research, as well as in many others, there are factors that affect the information content of the testimony. The results are highly dependent, for example, on whether the child is sleeping or awake. Experienced doctors, when deciphering cardiotocograms, also take into account such factors as weather conditions, the mood of a pregnant woman, and the level of glucose in a woman's blood. If the CTG data does not correspond to the norm, then the doctor will prescribe an additional examination. Usually, cardiotocography is performed twice in the third trimester of pregnancy, but in some cases more, for example, with multiple pregnancies, high blood pressure, infections, diabetes, poor ultrasound results, bleeding, premature contractions.

Possible errors in the interpretation of CTG data

The baby in the womb is in constant motion. Sometimes he can press the umbilical cord with his head, because of which the blood flow in the vessels of the umbilical cord is disturbed for a short time, which is reflected in the results of CTG. In this case, the cardiotocogram will have a pathological character with a good condition of the fetus.
Sometimes during the fetus, protective reactions are activated: there is a decrease in oxygen consumption by tissues and an increase in resistance to hypoxia. In such cases, the child suffers, but this does not affect the CTG.
With the development of pathology, the ability of tissues to perceive oxygen at its normal content in the blood may decrease, due to which the fetus does not have any reaction, and CTG will be normal, although it suffers from a lack of oxygen.

Given all of the above, you need to understand that fetal CTG during pregnancy is a very important diagnostic method, but in order to get a complete picture of what is happening, CTG data must be compared with data from other studies. To date, ultrasound diagnostics and dopplerometry are widely used.

Where can I do a fetal CTG

CTG is done free of charge in all antenatal clinics. You can conduct a study in private medical centers, but on a paid basis.

In maternity hospitals, cardiotocography is also performed during childbirth. This helps to assess the well-being of the child in childbirth and uterine contractions, to check the effectiveness of the treatment and tactics of childbirth.

Some expectant mothers are afraid to conduct various kinds of research during pregnancy, believing that they can harm the health of the unborn baby. Cardiotocography is absolutely safe, and you can do it as many times as necessary, without risk to health. In addition, it is painless, does not cause any discomfort.

We wish you an easy pregnancy and excellent health!

Exactly in order to monitor the health and comfort of the baby, in time to notice and try to change unnecessary deviations, the gynecologist prescribes various tests and additional studies to the pregnant woman.

Such surveys can be considered cardiotocography(abbreviated CTG), today this method is one of the most valuable, it allows you to determine the state of the fetus.

So, what is CTG during pregnancy? it registration of contractions of the baby's heart muscle, as well as contractions of the mother's uterine walls.

In our country, fetal CTG began to be used quite recently, just a couple of years ago. Most often, it is carried out in combination with doplerometry and ultrasound, this allows you to accurately find out how the child feels.

How long is CTG performed?

In some cases, doctors may order a study from 28 weeks, however, the most informative indicators are obtained after 32 weeks.

This happens because nerve and muscle impulses of the fetus mature at a later date i.e. at 32 weeks. Also, by this time, the child has a cycle of periods of activity and rest, which is also important.

When conducting CTG at a time when the baby is most often at rest, the results will always be positive, even if he has some kind of deviation (for example, a high degree).

That's why do not worry in the early stages that you did not have it. The right time will come and the doctor will prescribe a CTG.

During routine examinations of a pregnant woman, the gynecologist every time calculates baby's heart beats using a special stethoscope. The method allows you to study the contractions of the heart muscle - how frequent they are, normal or too rare.

Based on this, the doctor makes a conclusion about the state of the child, whether he is experiencing discomfort. If abnormalities are detected, the pregnant woman is immediately sent for cardiotocography., it will allow a more accurate diagnosis.

CTG is performed for 40-60 minutes, this time is necessary to more carefully analyze the dynamics of heart rate and their dependence on uterine contractions.

When conducting an examination the comfort of a woman is very important- if she lies in an uncomfortable position, the child will feel it and move more actively. As a result, false readings will be reflected on paper.

CTG shows normal results in 95 percent of 100 women, whose pregnancy proceeded in a calm manner, there were no threats of interruption, and there were no suspicions of congenital pathologies, symptoms after ultrasound.

This the relationship between the state of the baby and the well-being of the mother, scientists have long identified. In the event that the study shows poor results, and the pregnant woman feels great and no changes for the worse happen to her, the doctor should prescribe a second examination in a week.

If a pregnant woman often feels unwell, tests show poor results, significant changes occur in health, the gynecologist prescribes CTG as often as possible in order to identify possible deviations, fetal hypoxia in time and take measures to eliminate them.

Should know that a more complete and accurate conclusion on the results of CTG during pregnancy can be achieved only after several examinations, once may not be enough.

What is the norm?

All the results of KGT are reflected on the tape in the form of a curved line, with its help the doctor can accurately tell what condition the baby is in, if there are any deviations.

Normal performance:

heart rate(HR) or basal rhythm should be at rest of the fetus from 110 to 160 beats per minute, in motion - from 130 to 190 beats. The rhythm must be even;
rate of rhythm variability(height of deviations) should be from 5 to 25 beats per minute;
slow heart rate(deceleration) should be as rare as possible, their depth should not exceed 15 beats per minute. There shouldn't be slow decelerations at all;
number of accelerations(the frequency of contraction of the heart muscle accelerates) - more than two in half an hour, the amplitude should be about 15 beats;
less than one is normal fetal index;
uterus activity(tokogram) should be no more than 15 percent in relation to the baby's heart rate for 30 seconds;
all of the above studies are evaluated on a 10-point system, as a result a set of 9 to 12 indicates the normal condition of the child.

Deciphering indicators

As already mentioned above, the result is given on a paper tape. Newer models of the device immediately analyze the results and print out the already calculated indicators and points.

Only an obstetrician-gynecologist can decipher KGT, since this process requires certain skills and experience.

Very often, the results of the survey depend on changes in weather, mood, well-being of a pregnant woman and much more. All this a good doctor takes into account when deciphering.

Most often, the gynecologist does not explain to the expectant mother what this or that indicator means., because without additional training it is quite difficult to understand them.

Therefore, the doctor simply reports whether there are deviations or not. Below are the transcripts of each term, this will allow you to get at least a general idea of the results and you will know what indicator can be considered a bad CTG during pregnancy.

Each criterion gets a score from 0 to 2, all points are calculated, and a total indicator is obtained, which means the following:

9-12 points show that the child is all right, no abnormalities were found. The doctor may advise further observation;
6-8 points show that the child develops moderate hypoxia (oxygen starvation). To clarify the result, the doctor prescribes a second study every other day;
5 or less points indicate that the life of the fetus is in danger, since it has severe oxygen starvation. In some cases, urgent treatment is prescribed, sometimes a pregnant woman is sent for unscheduled treatment.

The main indicators of fetal cardiac activity:

Basal Rhythm(frequency with which the heart beats or heart rate) - if the child is in a calm state, beats per minute of less than 110 and more than 160 should be considered deviations. If the baby moves, beats of less than 130 and more than 190 per minute are not normal.
Heart rate range or variability- the average number of deviations from the norm is calculated. If it is less than five and more than 25 beats per minute, this is a deviation.
Acceleration(moments of acceleration of heart contractions) - on the graph they are shown as teeth. Deviation is considered to be less than two peaks per 10 minutes of active fetal movement.
Deseleration(that is, slowing down contractions) - on the graph it is shown with teeth down. In the normal state, it is absent, but it can be fast and shallow or slow (which is the worst).
Fetal Index (PSP)- minor violations are indicated from one to two, and serious deviations - more than two.

If even one indicator exceeds or falls short of the norm, this may presumably correspond to disorders in the child.

Is it harmful to conduct CTG for a pregnant woman?

Cardiotocography - absolutely safe examination She has no contraindications. Expectant mothers are very worried about the health of their babies and therefore every study is perceived with caution, in this case we can say with confidence that CTG is not at all harmful.

During the procedure, the pregnant woman does not experience pain., she is not injected with drugs, the skin is not damaged or pierced, there is no need for injections and the like.

CTG can be done at least every day especially if necessary, it can be repeated for a long time.

Should not be abandoned, because the timely detection of deviations and violations will save the future baby with the help of various procedures.

Where can I do CTG?

Free cardiotocography is most often carried out in the antenatal clinic or nearby maternity hospitals, ask a gynecologist about this.

If someone is not satisfied with the results of such a survey, you can contact paid medical centers There are plenty of them in every city. Addresses can be found on the Internet or the information service of the city.

It should not be forgotten that based on the results of CTG alone, the doctor cannot make an accurate diagnosis, he needs to additionally conduct doplerometry of the vessels of the placenta and ultrasound.

If these studies also show poor results, then the doctor can put hypoxia and prescribe the correct and effective treatment.

This is especially important in the last two months of pregnancy, at which time the child is almost formed and for a comfortable existence he needs a sufficient amount of oxygen. Don't forget about it and follow all the requirements of the gynecologist on time.

After 7 months of pregnancy, the expectant mother can get a referral for CTG. This study in the last trimester is considered one of the most informative. However, it is precisely this that causes the most questions among pregnant women, since it is completely unclear how and what is being investigated and how to understand what is written in the conclusion. In this article, we will talk about CTG in more detail, and also help to decipher its results.

What it is?

Behind the abbreviation CTG is a study called cardiotocography. At its core, it is a constant, continuous recording of the baby's heartbeats, uterine contractions, as well as the child's motor activity. All these parameters are fixed synchronously and are immediately recorded in real time by a chart recorder or a computer program on a calibration tape.

The rhythm of a beating baby heart is captured by an ultrasonic sensor, and uterine contractions are detected by a strain gauge sensor.

The first graph is called the tachogram and the second one is called the histogram. Due to its simplicity, safety and information content, CTG is today the most popular way to obtain information about the child's condition, which before the birth is very little - a couple of months.

CTG is prescribed for all pregnant women who are registered at the dispensary in the antenatal clinic. With an uncomplicated, normal pregnancy, the first study is carried out for a period from 30 to 32 weeks, then a similar examination is carried out immediately before childbirth in the maternity hospital during planned hospitalization. If the baby's condition raises questions, then CTG can be performed earlier, starting from 28-29 weeks. In case of serious complications of pregnancy, the examination can be carried out daily.

CTG is also used in the generic process itself. An examination during pregnancy, when the sensors are placed on the abdomen of the expectant mother, is called external or indirect CTG. Direct cardiotocography is performed when the integrity of the fetal membrane is broken, the water has broken, while a thin sensor-electrode is inserted directly into the uterus.

What does it show?

CTG allows you to find out how the child feels. First of all, the device captures and shows the heart rate (heart rate) - the main parameter that allows you to judge the well-being of the crumbs. An ultrasonic transducer based on the Doppler effect sends out an ultrasonic wave. It bounces off tissues and moving blood cells in the blood vessels and is sent back to the sensor. As a result it becomes obvious with what frequency the small heart beats.

The tone of the uterus and fetal movements are measured by a strain gauge, which is a wide belt encircling the belly of the expectant mother.

If the uterus contracted or tightened, if the baby made a coup or stretched, the stomach will change slightly in volume, which will not escape the sensitive sensor and will immediately be reflected in the graph.

There are some nuances in the study that are very important for correct diagnosis. So, not only the frequency with which the baby’s heart beats is important, but also how this rhythm changes depending on activity, movements and other factors. Therefore, rhythm variability, the myocardial reflex (when moving, the heart beats faster), as well as any other periodic changes in the child's heart, are evaluated.

Indications for examination

Like any other analysis or procedure, CTG during pregnancy is only a recommended technique, the Ministry of Health strongly advises pregnant women not to give it up. But the final word, in any case, remains with the expectant mother - if she does not want to go for this diagnosis, no one can force her.

Doctors try to do research for all pregnant women. But the procedure is especially indicated for certain categories of expectant mothers:

Any pathology of pregnancy. These include gestosis, oligohydramnios and polyhydramnios, the threat of premature birth, infectious and non-infectious diseases that the expectant mother suffered during the period of bearing the baby, chronic ailments that she has, high or low blood pressure in a woman, etc.
Strange child behavior. If the baby suddenly began to move rarely and sluggishly, or, conversely, his motor activity increased.
The appearance of pain in the abdomen of the mother. Any pain syndrome, of any nature and strength, necessarily needs a CTG.

Burdened obstetric anamnesis. The baby should be monitored more often with the help of cardiotocography if the woman’s previous pregnancies ended in premature birth, the death of the child in utero, and the birth of a child with gross developmental pathologies.
Severe previous birth or caesarean section. If such facts occurred in the past, then the next pregnancy in the later stages necessarily needs frequent monitoring, including with the help of CTG.

Women from the designated risk group can be diagnosed several times during pregnancy. The frequency is determined by a doctor who is well aware of the peculiarities of the course of pregnancy in a particular woman.

How is it carried out?

This simple examination can be done in the antenatal clinic at the place of residence, as well as in any private clinic that offers pregnancy planning and management services. The procedure is completely painless, it does not cause any discomfort.

In the doctor's office, the woman will be asked to make herself comfortable. She can lie down, sit down or sit in a semi-sitting position, the main thing is that she is comfortable, since CTG lasts quite a long time - from half an hour to an hour, and in some cases longer if the examination fails or its results are abnormal or questionable.

A wide special belt is put on the belly of the expectant mother - the same strain gauge, and a small round or rectangular ultrasonic sensor is fixed under it. They try to position the ultrasound sensor so that it is as close as possible to the baby's heart. As soon as the doctor hears a distinct rhythm, he will fasten his belt, fix the sensors and start the computer program, which will begin to record indicators and draw graphs. If the examination is carried out on an old apparatus, a recorder will draw.

Movement will be captured by a strain gauge belt. If the diagnosis is made on the device, then the woman will have a button in her hand, which she will be asked to press every time she feels a distinct movement of her baby. The decision to stop measurements is made by the program itself, as soon as the amount of information necessary for calculating the results is received, the “session” will end and the result will be printed.

Preparing for the passage of CTG is quite simple. On the eve, it is desirable to have a good rest, sleep, so as not to get distorted unreliable results. You should not go to the study on an empty stomach, it is best to eat before going out, and before going to the doctor's office, go to the toilet, because you will have to sit in one position for a long time. Along the way, it is worth walking to “cheer up” the baby, because the sleeping fetus will not be able to demonstrate the necessary physical activity.

According to expectant mothers, a small chocolate bar eaten before the procedure helps to wake up the baby.

Decoding and norms

Modern devices not only immediately after the end of the examination give the result for each of the determined indicators, but also assess the general condition of the fetus in points. We will talk about the scoring a little later, but for now let's look at what the basic terms mean and what it should be like in the norm.

Basal Rhythm

The rate of contractions of a small heart is constantly changing. This is the first thing a woman sees. In order to average indicators that vary from 120 to 180 beats per minute, a parameter such as basal rhythm was derived. During the first 10 minutes of the study, the device captures changes in heart rate and displays the average basal value. That is what is indicated opposite the line "Basal rhythm" or "Basic heart rate". The norm in the third trimester is considered if the base frequency is in the range from 110 to 160 beats per minute.

Rhythm variability

If the basal rhythm is an average value, then those very rapidly changing indicators of the heart rate of the crumbs are the variability. The term is used to refer to this parameter. "oscillations", which literally means "fluctuations".

These oscillations are either fast or slow. Rapid or (instantaneous) oscillations are oscillations that occur with each beat of the baby's heart. On the monitor, mom will be able to see them like this: 143, 156, 136, 124, 141 and so on, because the heart changes rhythm every few seconds.

Slow oscillations are also different. If in 1 minute the heart of the crumbs changes the rhythm by less than three beats (it was 140, now it is 142), then we are talking about low variability and low oscillations. If in a minute the heart changed the rhythm of the beat by a number from 3 to 6 beats (it was 140, it became 145), then we are talking about average variability. When the heart rate changes by more than six beats per minute (it was 140, it became 150), they speak of high variability and high oscillations.

Oscillations are high and instantaneous.

If the baby has low variability and instantaneous oscillations, this may indicate serious pathological conditions of the crumbs. This is often seen with hypoxia.

Slow fluctuations can be monotonous (if the heart rate has changed by no more than five beats per minute of the study), transient (the rhythm has changed by 6-10 beats), undulating (heart rate has changed by 11-25 beats in 1 minute), as well as jumping (more than 25 beats per minute). Wave-like slow oscillations are considered normal. Any other types of slow fluctuations are regarded as an alarming symptom. Jumping, in particular, occur when entwined with the umbilical cord, and transitional - with hypoxia.

Accelerations and decelerations

These are the same “teeth” and “failures” that are discussed by expectant mothers and visible on the chart. In simple terms, acceleration is the rise in the child's heart rate by more than 15 beats per minute and maintaining this pace for 15 seconds or more. On the graph, this is an upswing. Deceleration is a decrease in the rhythm by the same 15 beats per minute while maintaining the pace for 15 seconds or more. On the chart, they look like a failure.

2 or more accelerations per 10 minutes are considered normal. If the “peaks” on the chart repeat with the same frequency and last the same amount of time, then this may be a sign of fetal distress. Decelerations are not considered normal at all. Most often they talk about possible hypoxia, but minor “dips” can also be a variant of the norm, it all depends on the rest of the CTG indicators.

Fetal movements

Many expectant mothers believe that the number of baby movements per hour is the main parameter that determines CTG. This is not true. Already at least because there is no single norm for the number of movements of a child per hour. It is conditionally considered a good sign if the baby makes 6-8 or more movements per hour of diagnosis. The number of movements can be affected by the mood of the mother at the time of the CTG, and what she ate, and how her metabolism proceeds. The baby may be alert, or may want to sleep. That's why the number of movements is looked at only in conjunction with the rest of the diagnostic results.

The contractions of the uterine muscles look like smooth wavy lines on the graph, which is located under the graph of the fetal cardiogram.

Movements are noted in the same place, but they look like sharp rises, peaks.

A small number of movements may indicate that the baby is sleeping or in the resting phase, as well as that he has severe disorders, for example, oxygen deficiency. But no conclusions can be drawn from this indicator alone.

Uterine tone

Many pregnant women are concerned about the question of whether CTG will show uterine tone or hypertonicity. Answering it is not as easy as it seems. As mentioned above, CTG can be carried out in two ways - external and internal. The external method in question does not give an unambiguous answer about whether a woman has an increased tone. It only allows you to record individual contractions of the reproductive organ.

It is possible to accurately know the level of pressure inside the uterine cavity (and it increases with tone) only with the help of the introduction thin electrode-sensor into the uterine cavity. During pregnancy, for obvious reasons, this is impossible if the fetal bladder is safe and sound. And in childbirth, there is usually no need for such a measurement, because the baby has already gathered “to go out”, and measurements of external CTG will be informative, which will tell about his heartbeat and activity.

Therefore, by default, intrauterine pressure at the level of 8-10 millimeters of mercury is considered the norm.

If the program, when assessing the contractility of the uterus, shows values higher, they talk about tone, but indirectly and very carefully.

Contractions - true and false

Contractions are contractions of the muscles of the uterus, and they are displayed on the CTG chart. Moreover, both real contractions that accompany the birth process, and false or training contractions that precede the onset of labor, sometimes long before them. On the chart, real contractions are depicted as fairly large waves in the bottom line. Training will look similar, but the "waves" will be less pronounced, and the duration from the beginning to the end of the wave will be no more than a minute.

If we simplify all of the above, then the norms of CTG, under which it will be possible to say that everything is fine with the child, can be displayed in the following table:

Possible violations and their causes

Like any other diagnostic examination, CTG, or rather, its results, can raise a lot of questions, especially if the doctor says that "CTG is bad." What pathologies can be identified, we will describe below.

sinusoidal rhythm

The CTG schedule, which resembles even, identical sinusoids, usually does not inspire optimism for specialists. True, this happens quite rarely - once in 300-350 examinations, only in one woman theoretically cardiotocography shows a sinusoidal rhythm.

On the graph, decelerations and accelerations (ups and downs) are completely absent, while the base heart rate is quite normal, the variability does not exceed 15 beats per minute. Such a schedule usually does not bode well. This is how a child behaves with severe Rhesus conflict, significant fetal hypoxia, in case of poisoning of a pregnant woman and a baby with toxic substances or drugs.

If a woman has not taken poisons and drugs, the risks for the child increase. In this case, a sinusoidal rhythm may be a harbinger of imminent death. Almost 70% of children who demonstrated such sinusoids on CTG were born dead or died in the first hours after birth due to various reasons.

In order to judge the sinusoidality of the rhythm, like this, as in the picture, the graph should be “drawn” for 20 or more minutes. In this case, the woman is urgently hospitalized to perform an emergency caesarean section and try to save the life of the child.

High fetal heart rate

If a child has a clear excess of heart rate on CTG for 10 minutes, the base heart rate consistently exceeds the norm, we are talking about fetal tachycardia. At the same time, great importance is given to how exactly the main values \u200b\u200bare exceeded:

Heart rate \u003d 160-179 beats / min - a mild degree of tachycardia;
Heart rate = 180 beats / min and above - severe tachycardia.

The reasons that can make a small heart beat so often can be different. Most often, tachycardia is a sign of oxygen starvation. When a baby does not have enough oxygen, compensatory mechanisms “turn on” in him, which are designed to saturate tissues and organs with oxygen “for future use”. The heart begins to beat faster under the influence of stress hormones.

With a high heart rate, a baby in the womb can respond to a fever. If the mother's body temperature rises to at least 37.5 or 38.0 degrees, the baby will immediately demonstrate an increase in heart rate. If the mother is not sick and does not complain about a rise in temperature, the cause of such CTG may be infection in the baby. Intrauterine infection causes the baby's immunity to begin to produce antibodies and a variety of auxiliary substances that increase the temperature of the child himself and make his heart beat faster.

If the mother has taken any medication shortly before the study, this must be reported to the doctor.

Side effects of some drugs include an increase in heart rate, and not only in the mother herself. Tachycardia can be observed in the children of women suffering from an abnormal thyroid gland. In this case, the baby's body acts wrong hormonal background of the mother.

Slow fetal heart rate

A decrease in the baby's heart rate below normal values is called bradycardia. An alarming indicator is heart rate if it remains at the level of 100 or less beats per minute for 10 minutes of the study or more.

Slow heart rate may be due to severe hypoxia, representing a real danger to the life of the baby. Such indicators during the birth process indicate that the baby's head was tightly pressed when passing through the birth canal. In the second case, bradycardia is considered a variant of the norm, it is called reflex arrhythmia. Some medications that the mother took on the eve of the study can also slow down the heart rate of the child.

monotonous heartbeat

Such a violation can be discussed when slow oscillations (oscillations) do not exceed 5 beats per minute. There are no sharp fluctuations on the chart. If this schedule remains for 10-15 minutes of the study or more, the woman will definitely be asked to undergo additional examinations, for example, ultrasound with ultrasound, because monotony in most cases “signals” about hypoxia and other circumstances unfavorable for the baby.

Fetal hypoxia - oxygen starvation

All expectant mothers know how dangerous and insidious hypoxia can be. The oxygen deficiency that the baby receives with maternal blood through the mother-placenta-fetus system can lead to irreversible processes in the baby’s central nervous system and even provoke his death.

Signs of crumb hypoxia on a cardiotocographic examination are a decrease or increase in heart rate.

At the early stage of oxygen starvation, the heart beats more often than required by the norm, at the late stage of hypoxia, there is a decrease - bradycardia.

The baby, who suffers from a lack of oxygen so important for his development, will “demonstrate” low variability on CTG, accelerations that will be exactly the same in duration and severity, a sinusoidal rhythm and sharp, very frequent movements, which doctors call “painful movements”.

If CTG determines one of these signs, then the woman is sent for additional examinations. But detection of two or more alarming indicators is the basis for hospitalization expectant mother and speedy delivery by caesarean section.

Score by points

To summarize the results of cardiotocography, a scoring system is used. The evaluation of each of the above parameters includes the accrual of a completely certain number of points, which in total give the final result. In obstetrics and gynecology, there are several criteria for "awarding" points.

Fisher scale

Of all the methods for calculating the results, this one is considered to this day the most accurate and correct. When scoring on the Fisher scale, four main values \u200b\u200bare evaluated - the base heartbeat, variability, acceleration and deceleration. This scale was supplemented by Dr. Krebs, who also suggested taking into account the number of fetal movements. This resulted in a clear and simple scoring system:

Fischer rating table in Krebs modification:

The indicator determined on CTG	1 point is awarded if:	2 points are awarded if:	3 points are awarded if:
Base heart rate	Less than 100 bpm or more than 100 bpm	100-120 bpm or 160-180 bpm	121-159 bpm
Expression of slow oscillations	Less than 3 bpm	3 to 5 bpm	From 6 to 25 bpm
Number of slow oscillations	Less than 3 during the study period	3 to 6 per study period	More than 6 during the study period
Number of accelerations	Not fixed	1 to 4 in half an hour	More than 5 in half an hour
Decelerations	late or variable	Variable or late	Early or not fixed
perturbations	Not fixed at all	1-2 in half an hour	More than 3 in half an hour

Normal on this scale is considered if the condition of the fetus is estimated at 9-12 points. This means that the baby feels good, in any case, while the study was being conducted.

If the result of CTG according to Fisher is 6-8 points, then the woman needs further monitoring of CTG, because such an indication is a sign of the child's distress. However, it does not pose an immediate danger to the life of the crumbs. It is recommended to repeat CTG more often to monitor the dynamics.

The most alarming indicator according to Fisher is less than 5 points. This means that the child is in mortal danger, his death can occur at any moment. Usually, with such results, CTG is not sent home, but immediately to the hospital, where a decision on early delivery should be made within the next few hours in order to give the baby a chance to survive. This is the very case in which it is more dangerous for a child to remain in the womb than to be born, even if very premature.

FIGO scale

This scale was created by the International Association of Gynecologists and Obstetricians in order to “equalize” some errors in the assessment of CTG criteria by doctors from different countries. This is the international "gold standard".

FIGO score table:

Common Questions

What is a PSP?

In the conclusion that the pregnant woman will receive after undergoing cardiotocography, it will be indicated that the PSP of the fetus \u003d a certain numerical value. What is PSP is not too difficult to guess. This abbreviation is deciphered as follows: "an indicator of the condition of the fetus." This is a kind of summary that is issued after analyzing all the data received. It is not a person who calculates the PSP, but a special program, and therefore the personal factor and the qualifications of the medical staff do not matter here.

PSP is calculated by complex mathematical algorithms that the expectant mother does not need to know at all. It is enough to familiarize yourself with the general rules of the PSP as such:

Norm - 1.0 and below. A deviation from the norm, which is considered insignificant, for example, 1.03 or 1.05, is a reason to double-check the data, conduct CTG again, perhaps something just went wrong.

PSP \u003d 1.1-2.0. These numerical values indicate the initial disturbances in the condition of the fetus. In this case, CTG should be repeated once a week, the woman is prescribed treatment depending on the causes that caused the violations (fetal hypoxia, placental insufficiency, etc.).

PSP \u003d 2.1-3.0. Such indicators indicate that the baby feels severe discomfort, his condition leaves much to be desired. With such values in CTG, it is customary for a woman to be hospitalized in order to make the final decision in the hospital - to treat or give birth. If it is decided to keep the pregnancy, a cardiotocogram will be shown every 2-3 days.

PSP= 3.0 and above. This result is very worrying. Most often, it indicates that the baby is in critical condition. A woman is hospitalized immediately, sometimes by ambulance, within a few hours a decision is made to conduct an emergency caesarean section to save the baby's life.

Is the gender of the baby visible on the CTG?

The genitals of the child, as well as other features of his appearance and structure, are not indicated in any way on cardiotocography. The sensors that the doctor attaches to the belly of the expectant mother do not give an image of what is happening inside on the screen, they only “write” graphs.

To find out the sex of the baby, it is better to go for an ultrasound or donate blood for a non-invasive DNA test.

These methods will answer with great accuracy the question of who is growing in the stomach - a son or a daughter. Attempts to determine the sex of the child by the heart rate, which is determined by CTG, cannot be explained by any scientific arguments. Folklore says that a boy's heart beats less than a girl's heart. . Traditional medicine can neither confirm nor deny this - this pattern has not been studied.

How to do CTG during twin pregnancy?

This question interests many, but the answer to it is not so simple. One sensor can register parameters for only one baby. If there are two or more children in the mother's womb, this can cause a lot of technical difficulties during the procedure.

To avoid confusion when assessing the condition of two or more babies, the doctor will first determine the location of each of them. Separate ultrasonic sensors will be attached to the area close to the heart area of each baby. If there are two children, then there will be two ultrasound sensors, if there are three, then there will be three sensors. But the strain gauge, as in normal pregnancy, will be one. Thus, a woman will receive two or three graphs, the same number of conclusions on the condition (PSP) of each of the babies she bears.

What is a positive and negative non-stress test?

Additional tests can make CTG results more accurate. CTG with functional tests can be prescribed separately if the results of the first study turned out to be “suspicious”, doubtful or borderline (between the norm and pathology). The tests are different. A stress test is a registration of the reaction of the fetus, its heart rate and other parameters after the introduction of a pregnant woman with a small dose of oxytocin, which causes uterine contractions.

A woman may be asked to walk briskly up the stairs before the examination, hold her breath from time to time, all of these will be options for stress tests.

A non-stress test is when no load and provoking factors from the outside are observed on the child, and the baby will respond to its own movements with an increase in heart rate.

If acceleration after movement is not observed, this is an alarming sign, the test is considered positive. If in 40 minutes the baby makes at least two movements with accelerations, then the test is assessed as negative, and this is considered the norm.

What will the study show if the baby is sleeping?

If the examination is carried out at the moment when the baby is in the resting phase, then his movements, like a sleeping adult, will be minimized. The CTG will record the heart rate, as well as episodic uterine contractions, but there will be no movements or they will be single, there will be no accelerations associated with them. In this case, the doctor will take all measures to wake up the "sleepy", if this does not work out, that the woman will be advised to come to the CTG again, in a few days.

What will the study show if a woman has oligohydramnios?

Cardiotocography cannot confirm the fact of oligohydramnios (as well as polyhydramnios), this can only be clarified by ultrasound. However, with the established fact of oligohydramnios, CTG will be done more often. If the results in dynamics indicate the prenatal suffering of the child, then the woman will be shown early delivery. This is not always the case, and many expectant mothers with oligohydramnios get excellent results of cardiotocography.

Can CTG harm the fetus?

Cardiotocography is considered a completely safe method for the child and mother. Despite this, many women argue that doing ultrasound is harmful, as well as CTG, where an ultrasonic sensor is also used. The harm of ultrasonic radiation for the development of the child has not been proven. True, it is not yet possible to assess the isolated consequences of exposure to ultrasonic radiation on a person (in ten, twenty or forty years).

Thus, only illiterate actions of medical personnel can harm the baby, which can tighten the strain gauge-belt on the pregnant belly too tightly, causing mechanical compression and even injury to the fetus.

Do CTG parameters change week by week?

It makes no difference how long the CTG is performed. The parameters that are determined in this study do not depend on the height, head circumference, chest or limb length of the child, as is the case with ultrasound. Therefore, the results of CTG at 33, 35 and 36 weeks will not differ in any way. If the child is comfortable and well, then this is exactly what the graph will show.

Experienced obstetricians, however, note one curious detail - the baby's heart begins to beat a little less frequently at 32.34, 36 and 38 weeks.

Can the procedure be done at home?

Theoretically and practically, this is possible, but the cost of devices for cardiotocography is high (several hundred thousand rubles), and small amateur devices that only record the heart rate and do not record or analyze other parameters have no special diagnostic value.

Sometimes, when the situation requires daily monitoring, a woman is temporarily provided with a device for home use, this decision is made by the attending physician. Most often this happens with patients of modern perinatal centers, which are better equipped than consultations.

Home measurements will be able to show the condition of the baby, as well as understand that there will be childbirth soon, if the baby is moving strongly or, conversely, has calmed down, and characteristic “waves” appear on the graph, indicating the onset of contractions and preparation for childbirth. This can happen at any time, starting from 37-38 weeks. Women whose onset of labor should not coincide with their stay at home are advised to go to the maternity hospital in advance. In a hospital setting, if necessary, a daily CTG will be performed, and the expectant mother will not have to worry about the condition of her baby.

For information on how CTG is carried out, as well as other useful information on pregnant women, see below.