Hospitals 

CTG algorithm for pregnant women with one belt. Can I drink coffee before CTG? How often do CTG for pregnant women and is it possible to do it every day

A type of diagnostics (CTG) is carried out only in a specialized clinic and under the guidance of specialists, since it is necessary to have equipment designed for this purpose. Cardiotocography or, in other words, CTG is done for a reason, but you need to properly prepare in order to get the right indicators, for example, Short Term. When visiting CTG, you need to spread a sheet on a couch specially designed for this and lie on your side. Basically, this is the right side or half-sitting state.

What is it: CTG during pregnancy

It is worth noting that how long the study lasts directly depends on the condition of the pregnant women, on how long the examination is carried out and in what period, for example, stressful or non-stressful. During the diagnosis, you can drink and even talk, as this will not affect the condition of the fetus, and even more so the data obtained.

Namely, you need:

  1. The procedure should not be done on an empty stomach, for example, if the last time the procedure was carried out when the child was sleeping, then you can eat a piece of chocolate, which will make him a little more active.
  2. Go to the toilet first, as the process of obtaining results in this way lasts about 40 minutes.
  3. Turn off your phone and other devices that may cause interference.
  4. Move before the study to wake the child.

In any case, a position is chosen in which nothing will compress the uterine cavity. Then the specialist connects the device using belts and sensors that are located in the abdominal cavity.

Correct interpretation of CTG results

The decoding of indicators is carried out according to strictly established rules, and only an experienced specialist can decipher the data. First (Daws Redman's Figo criteria) examines how often the heart beats. The norm should be 116-160 beats per minute. In addition, bradycardia is examined, the norm, which is considered to be less than 100, and how many beats per minute are performed when checking the pulse, which in an elevated state can reach about 180.

In order to conduct CTG, there are several prerequisites.

  • Planned diagnostics;
  • Suspicious fetal activity or lull;
  • Poor condition of the mother;
  • The period before childbirth.

Next, heart rate variability is examined. In other words, a study is made of the amplitude of fluctuations or deviations from the main line of the basal frequency. There should be indicators in the range of 10-25 beats per minute and a frequency of no more than 6. In other words, there are about 6 jumps in the form of a deviation from the basal frequency per minute.

There is a difference in the type of rhythm that happens: monotonous, undulating, slightly undulating and saltatory.

The presence of an undulating or saltatory rhythm, or an indication of variability in the form of 9-25 times per minute, is considered the norm. If a monotonous or slightly undulating appearance is set, and the variability is less than 9 times or more than 25 times per minute, then this becomes a clear sign of fetal hypoxia. During this study, an assessment of the myocardial reflex is also carried out. In other words, with the fetus's own movements, the child's heart rate may increase, during which acceleration is registered. This is also a type of non-stress test.

In turn, a stress test is monitoring the fetal heart rate when exposed to the nipple area of ​​a pregnant woman, which provokes the release of a hormone that contributes to an increase in uterine tone.

External and indirect fetal CTG: what is it

CTG is performed weekly and, if it is completed successfully, this means that neither the fetus nor the expectant mother has any pathologies. If the diagnosis of data such as pulse and similar information shows normal indicators, then you can not worry and not resort to treatment, if necessary.

There are 3 types of CTG:

  • Indirect;
  • External, carried out most often;
  • direct or internal.

Direct research is required only during childbirth, when the fetal bladder has already been opened. To measure the fetal heart rate, a needle electrode is used, which is inserted into the presenting part of the fetus. Thus, uterine contractions are recorded or, in other words, contractions are tracked. Now direct CTG is used especially rarely, since there are simpler and more effective ways to diagnose the condition of the fetus and mother at the same time.

What is the norm of CTG during pregnancy

To make CTG, certain conditions must be met, which were written above, and a special apparatus must also be used. The concept of the abbreviation CTG stands for cardiotocography, for which a special recording device is used, as well as sensors that are installed on the abdominal cavity with elastic belts, an ultrasonic sensor, through which the frequency of contractions of the fetal heart is recorded.

The last sensor is placed on the area of ​​the abdomen where the heart rate is best heard and the place may vary depending on the gestational age, the position of the baby in the uterine cavity, for example:

  • Longitudinal;
  • oblique;
  • transverse.

There is a special table according to which the obtained indicators are compared with the norm or vice versa, a deviation from the norm, and what the sensor produces is called a tachogram. The abscissa axis displays the time in seconds, or in other words, the period during which the woman was examined. The y-axis displays the baby's heart rate.

To monitor the contractile activity or the presence / absence of uterine contractions, a strain gauge is used, which should be installed on the right corner of the uterine cavity, since it is from this place that the cramping wave is formed in the period before childbirth.

The deceleration graph, the acceleration of which is issued by this sensor, has a name - a hysterogram. The line shows whether contractions are present or not, and whether tone is present or absent. Modern devices for recording CTG are equipped with many additional functions that allow you to track all the necessary data in a minimum amount of time and, in particular, distinguish fetal movements from the movements of the mother so that they do not blur diagnostic information.

How and what should CTG show during pregnancy

The reason for the deterioration of the fetus may lie in a variety of factors. For example, an increase in the child's reactivity depends on how active the mother is. Every mother-to-be knows that many factors can affect the condition of a child in the womb.

For example, it has a very strong effect:

  • Weather:
  • Emotional mood of the mother;
  • Surrounding atmosphere and furnishings;
  • Food and beyond.

If in the later stages there is an increased tone, a decrease or increase in fetal activity and other pathologies, then CTG is required, a diagnostic method during which the baby's heart rate is continuously recorded. CTG is an informative and completely safe diagnostic method, with the help of which, in a minimum amount of time, you can get information about the crumbs in the womb.

CTG parameter 8 points: what does it mean

CTG is started with the woman in a horizontal position, and during the procedure, the output parameters are recorded. Everything is done automatically by the device itself. It is worth noting that each index obtained affects what score will be given after the end of the diagnosis. 8-10 is normal. 6-7 there are doubts about the normality of the state. Less than 6 points is the moment when his condition is dangerous for the baby, and the help of a doctor is required.

Regardless of the scores that were obtained in the previous CTG study, the next one is carried out taking into account the same criteria.

That is, all actions are similar, but there are various moments when CTG needs to be performed, and it can be planned or emergency, which depends on certain parameters. It is worth noting that in addition to CTG, a woman during pregnancy must undergo research.

Namely:

  • Blood and urine analysis;
  • An analysis for HIV, AIDS, etc., which, of course, must be negative.

As a rule, the planned conduction of CTG begins from the 32nd week of pregnancy, and during the 3rd trimester it should be carried out every week if the period of fetal development is successful. CTG in childbirth is performed when a woman enters the maternity hospital, the uterus is fully dilated, there is no dilation and the presence of too strong contractions, every attempt.

Approved norms: fetal heart rate by week

CTG (incorrect KGT) control is a series of indications in which this study should be carried out more often. With multiple pregnancies, it is important to monitor the condition of each baby, since the distribution of nutrients is 2 times stronger, and there is a possibility of developing pathologies in one of the twins, especially if it is monochrome twins. With oligohydramnios, to eliminate the risk of hypoxia. With polyhydramnios, in order to exclude pathologies, as metabolism is disturbed. With a post-term pregnancy, if the period has already reached 41 weeks and 4 days. With a decrease in fetal activity.

Each examination must be carefully told to the doctor:

  • All sensations;
  • How often does the fetus move?
  • How often does he calm down;
  • Which contribute to the 2 previous factors;
  • Which can lead the baby to a stressful state, for example, to the fact that he will begin to flounder inside the womb.

It is according to such data that the doctor can draw conclusions, reviews about, firstly, what condition the child is in and secondly, what exactly can threaten him. If there is a suspicion that the fetus is threatened by hypoxia or premature birth, an additional ultrasound and dopplerometry is required.

If the baby is monitored for the presence of a placental disorder, then this indicates placental insufficiency accompanied by hemodynamic disorders or, in other words, a violation of blood flow in the uterine cavity and umbilical artery.

This can be even provided that the woman is completely healthy and has no pathologies, but most often it occurs in those who smoke, consume alcohol, have heart and lung diseases, and belong to the age group over 35 years. Also, the implementation of CTG should be carried out in an emergency mode for preeclampsia and a burdened obstetric history.

What is CTG during pregnancy (video)

All studies listed above should be carried out only by a qualified specialist with the education of an obstetrician-gynecologist.

During pregnancy, a woman takes a lot of tests, starting with general ones - blood, urine, and ending with specific ones, which are prescribed much less frequently for certain indications. One of these studies is the measurement of heart rate (HR) and the response of fetal cardiac activity to uterine contractions.

CTG is a highly informative method, which is almost on a par with ultrasound examination and doppleometry. Based on its results, you can see a complete picture of the state of the developing fetus, evaluate the work of the cardiovascular system, and subsequently adopt the correct tactics for childbirth, as well as fully control their process.

Wanting to get detailed information about the cardiac activity of their baby, many women in the position are wondering how long they do CTG or how often should this diagnosis be done? This study has certain features that are determined by the development of the organs and systems of the fetal life.

About Fetal Cardiotocography

CTG is an ultrasound examination based on the Doppler effect, in which waves are reflected from moving objects. With it, heart rate is measured not only at rest, but also changes are noted against the background of fetal movements, uterine contractions, and also under the influence of various external conditions. Due to the ease of implementation, absolute harmlessness and painlessness, as well as high information content, such an examination is used quite often. It is used to monitor the condition of the child in the womb and is indispensable at all stages of labor.

CTG does not cause pain or discomfort and is absolutely harmless

When is a fetal heart test scheduled?

Until the 18th week, the cardiac activity of the fetus is not regulated by the autonomic nervous system, and only at the 19th week of development, parasympathetic nerve endings begin to approach the heart muscle. It is only then that the child's physical activity begins to affect the heart rate, reducing them. The nerves of the sympathetic department sprout by the 28th week and cause a backlash - the activity of the baby speeds up the beating of his heart.

The procedure itself can actually be carried out from 23–24 weeks, but it will not yet be possible to give a correct interpretation of the data. At this time, an increase or decrease in heart rate may be due to the ingestion of biologically active substances from the mother's body into the blood of the fetus. And also a clear cycle of activity and rest of the fetus has not yet been developed.

Only by week 32 will the frequency of sleep and rest of the baby be formed, and the heart rate will become dependent on the movement of the child.

Planned appointment of the survey

When asked how many weeks CTG is done, it is unequivocally stated in the order of the Ministry of Health, which sounds like this: “In a normal pregnancy, the first CTG is done at 28 weeks, and then every ten days.”

But as practice shows, obstetricians who observe the course of pregnancy recommend undergoing CTG in the absence of any violations 2 times a month, starting from 32 weeks. In complicated pregnancy, other intervals are used.

Appointment for complicated pregnancy

For a pregnancy that occurs with complications, there are the following recommendations for undergoing CTG, which should be followed to control the situation:

  • when the pregnancy is overdue - every 4-5 days after the due date of delivery;
  • conflict of blood groups or Rh factors - twice a month;
  • with a decrease or increase in the volume of amniotic fluid and heart defects - every week;
  • placental insufficiency and thyrotoxicosis - weekly.

Every 10 days, CTG is done for pregnant women with a narrow pelvis, with a large fetus, placenta previa without bleeding. And also with a history of rubella, hypertension, inflammatory processes in the genitourinary system. Be sure to do fetal CTG for expectant mothers after the age of 35 years. If the activity of the fetus decreases or it freezes for several hours after 32 weeks, cardiotocography is immediately prescribed - you may have to induce premature birth to save the baby.

CTG - reliable help in choosing the tactics of childbirth

Cardiotocography is not a fundamental diagnostic for choosing the tactics of childbirth, but thanks to it, you can keep the situation under control both before delivery and at the beginning of labor. In many cases, this study can help in choosing the tactics of childbirth. Since the procedure can be carried out often, there is an excellent opportunity to make the right decision in the shortest possible time.

If it was planned to carry out childbirth in a natural way, and labor activity does not begin - the pregnancy is overdue, then CTG is done:

  • on the expected day or the next;
  • with good results - every 4-5 days.

At the onset of 41–42 weeks, a consultation of doctors determines the tactics of childbirth - to stimulate, wait for more, or use an operative method. In such a situation, you should definitely do CTG - this will allow you to choose the best option.


The study allows to identify severe fetal pathologies

How to keep childbirth under control?

Cardiotocography during childbirth is carried out for absolutely all women, regardless of the situation, as this allows you to identify the slightest violation of the child's condition and, without wasting time, take emergency measures if necessary. For contractions in uncomplicated labor, it is necessary to perform the procedure every 3 hours, and in the presence of complications, it is recommended more often or continuously.

The study allows the obstetrician to understand how the child endures the birth load. The normal heart rate between contractions is 110-160, then in the presence of hypoxia, the frequency increases above 160, and then decreases. This is a kind of signal for doctors to stimulate the birth process. Depending on the situation, you can choose one of several possible ways for the speedy delivery: obstetric method, forceps or vacuum extractor, perineo- or episiotomy.

When hypoxia appears, while the baby's head has not yet sunk into the pelvis, a caesarean section is performed. With signs of hypoxia on cardiotocography, a resuscitator must be called.

Conducting research

The procedure itself is quite simple in its way of conducting and does not take much time. The obstetrician determines the optimal time when to do CTG during pregnancy and explains to the expectant mother how to prepare in order to get the most informative results.

Preparation

To undergo the procedure, a woman does not need to perform any complex preparatory techniques, it is enough to sleep well, eat and stay calm. Stress or bad mood can lead to distortions in the results. Be sure to visit the toilet, given that the procedure can take up to an hour or even up to an hour and a half.

Before CTG, it is recommended to eat chocolate, as an increase in maternal blood sugar will contribute to the activity of the fetus. Often there are situations when, during the procedure, the baby sleeps and you have to wait for the change of the sleep phase to the wakefulness phase, which takes 30–40 minutes and significantly delays the examination. A similar reception with sweets will solve this issue.

The doctor should inform the pregnant woman that the procedure will take place in a prone or half-sitting position and recommend taking a pillow with you for a comfortable position during the examination.

Some time before the start of the study, it is necessary to walk around, stretch a little - this will help bring the baby out of the rest phase.

The most reliable results are obtained while the fetus is awake. Due to the influence of many factors on obtaining analyzes with CTG, 2-4 procedures are performed over several days in order to obtain the most accurate results.

The course of the procedure

To successfully take readings, a woman needs to comfortably sit on the couch - reclining or in a position on her side. You should not lay on your back - this is both inconvenient and can negatively affect the results.

To get a record of the baby's heart rate and uterine contractions, the diagnostician uses a stethoscope to find the place where the baby's heart signals are heard most accurately. In this place, an ultrasonic sensor is fixed on the abdomen of pregnant women using belts, which fixes the fetal heartbeat, and a strain gauge is installed in the lower abdomen, catching uterine contractions.


Some devices are equipped with a special sensor or a kind of remote control that a woman holds in her hands and presses when the fetus moves to record its activity.

The baby's heartbeat and uterine contractions are recorded by sensors and processed by the device's program, which are subsequently displayed on the monitor screen. Many devices reflect data on fetal heart rate and uterine contractions in separate graphs.

Is there a threat to the baby and for how long?

The data obtained is recorded on electronic or paper media, resembling a tape for a cardiogram of the heart, and deciphered by a specialist. Of course, the doctor conducting the procedure immediately sees obvious deviations and, if urgent measures are needed, immediately reports this.

In situations where the baby's condition is not critical, the results can be given to the woman, and she goes with them to the obstetrician for a more thorough decoding and, if necessary, for further recommendations. And here, every caring mother, being interested in the health of her unborn child, can look into the schedule and get acquainted with the activity of his heart. In this case, it is better to have an idea about the norms and possible deviations in the tokogram.

Heartbeat

The maximum and minimum values ​​​​of the fetal heart rate are recorded on the cardiogram, but the diagnostician is interested in the average rate, the norm of which is 110–160 beats per minute.

Variability

After the heart rate, the frequency and amplitude of contractions of the baby's heart are evaluated. The tokogram curve shows many small teeth and several high ones. Small are deviations from the basal rhythm. Normally, at 32–39 weeks there are no more than 6 of them.


Evaluation of indicators is carried out according to several parameters and then they are added

But counting them is not so easy, so most often doctors give an estimate of the amplitude of deviations, expressed in changes in the height of the teeth, the norm of which is 11–25 beats per minute. A decrease in this indicator to or less than 10 strokes may alert doctors.

However, it is necessary to take into account how many weeks CTG is performed - if the period is less than 28 weeks, then this is not a pathology. If the period is longer, then the procedure should be repeated - perhaps the baby was just in a state of sleep. Exceeding the norm of this indicator may indicate entanglement with the umbilical cord or the presence of hypoxia.

Acceleration and deceleration of heart rate

To assess this indicator, high teeth on the tocogram are studied at 32–38 weeks of gestation. When undergoing a procedure on outdated devices, a woman is asked to press a special remote control when the fetus moves. Modern devices no longer need this action - they automatically record the activity of the baby.

When the child moves, his heart starts to beat faster and this is displayed on the graph by a high tooth. This is called acceleration and its norm is considered to be at least two in 10 minutes. Acceleration may not be displayed during the study, but do not panic - perhaps the child is just sleeping.

Slowdown - at 35-39 weeks looks like teeth growing down. There is no need to worry if after the acceleration there is a short and shallow deceleration, and then the graph returns to the average rhythm. High-amplitude decelerations are dangerous. In this case, it is necessary to compare the first graph with the second one, on which uterine contractions are recorded - they can slow down the rhythm.

The advantages of cardiotocography are obvious - thanks to it, you can control the condition of the fetus, prepare for the upcoming birth, identify problems with the development of the child in time and find solutions. In addition, the procedure is absolutely painless and harmless to the mother and child, therefore, if mothers are concerned about the question of whether CTG is harmful or how long it is better to undergo it, then the answer is not harmful, and the doctor will choose the term himself, guided by the well-being of the pregnant woman and the prescribed norms.

Cardiotocography is an important study of a still very small human heart and helps to identify pathologies at an early stage, to begin to correct problems. What does fetal CTG show, how to decipher the tests and how to determine if the baby's condition is normal?

What is CTG in pregnant women

CTG during pregnancy is a method for assessing uterine contractions and the baby's heartbeat, which is still developing in utero. The study is important because it allows you to identify deviations from the norm at an early stage. Doctors, using an apparatus for listening to the fetal heartbeat, determine this procedure as mandatory for the expectant mother, like ultrasound and dopplerometry.

A check with a cardiotocograph is prescribed, starting from the 30th week, only women who have indications for CTG during pregnancy are examined before this period. The procedure confirms whether the baby is healthy, whether there are dangerous pathologies for the pregnant mother or baby. If the specialist has identified any anomalies, then the doctor from the antenatal clinic should correct the process of pregnancy management, and in some cases, therapeutic measures are taken. These diseases include:

  • hypoxia in a child;
  • oligohydramnios or polyhydramnios;
  • functional disorders in the placenta;
  • fetal tachycardia;
  • disorders of the cardiovascular system.

When is fetal cardiotocography indicated?

Heartbeat and uterine contractions on CTG are checked in such cases:

  1. If the condition of the baby and mother is normal, then CTG is done once during a normal pregnancy. If the recording recorded pathological changes, a re-recording is assigned. The procedure is carried out from the 30th week of pregnancy.
  2. If past pregnancies were unfavorable (death of a child in utero, genetic and chromosomal disorders).
  3. Feelings of the mother that something is wrong with the child. Every mother already knows how the baby behaves in the womb. If there is a change in the regimen, the activity of the child, then the pregnant woman should pay attention to this.
  4. With the course of acute diseases (flu, tonsillitis, SARS), chronic infections in a pregnant woman and outpatient or inpatient treatment.
  5. With gestosis in a pregnant woman.
  6. If a woman is subject to bad habits: during pregnancy she smokes, takes alcohol or drugs.
  7. If the pregnant woman suffers from chronic diseases of the internal organs.
  8. If the pregnancy is delayed.

At what time do fetal CTG

If the pregnancy proceeds normally, there are no complications, then CTG is recommended to take place in the third trimester 1-2 times. If during the first studies some pathological changes are detected, then an additional examination procedure is prescribed. A check-up procedure is carried out during childbirth in order to comprehensively assess the general condition of the baby. During the contraction, a CTG record is kept, according to which the condition of the child is assessed, and decisions are made on further delivery. This is especially true for babies with cord entanglement.

Why do CTG pregnant

Using only this research method, one cannot be sure of the reliability of the diagnosis. The condition of the baby inside the mother can change due to the medication taken by the woman, depending on the food taken, mood, reactions to external stimuli. CTG helps to identify such pathologies during pregnancy:

  1. Umbilical cord wrap. This condition is dangerous by a violation of the supply of oxygen from the mother to the child. Blood flow not restored in time can lead to a serious condition.
  2. Irregularity of the fetal heartbeat. This is a signal that there are anomalies of the heart.
  3. Hypoxia. During the study, small signs of pathology will be noticeable.

The procedure is carried out quickly, which gives real chances to assess the condition of the child even during childbirth, to resolve labor activity as correctly as possible. If the mother has pathologies that affect the fetus, then the woman is sent to the hospital, observed and recorded daily. If abnormalities are detected, the expectant mother is examined for ultrasound and dopplerography is performed. If the diagnosis is confirmed, then treatment is prescribed, in which CTG is done 1-2 times daily to assess the effectiveness of the treatment, monitor the condition of the fetus.

How is CTG performed for pregnant women and during childbirth

The procedure is safe, but you need to prepare. A woman should sleep well, not experience nervous breakdowns, stress, be completely calm. In order for the study to give the most accurate result, the child must be active. To do this, the mother needs to eat something sweet before the procedure, preferably a chocolate bar. The woman takes a lying or reclining position, is conveniently located. A pressure sensor (load cell) and an ultrasonic sensor are attached to the abdomen. The first controls uterine contractions, the second controls the fetal heartbeat. The recording lasts 30-60 minutes.

Deciphering fetal CTG

The Fisher way of explaining the results is the most used and takes into account the following parameters:

  1. The average heart rate is the norm from 119 to 159 beats in 60 seconds.
  2. Fluctuations in the frequency of heart contractions - the norm is from 5 to 25 beats.
  3. The frequency of changes is the normal state with 6-10 teeth on the curve.
  4. An increase in the child's heartbeat (acceleration) - within 10 minutes at least 2 accelerations.
  5. Deceleration is the reverse process of the previous one, in the absence of pathology it should not be.

Each attribute is rated on a scale from 0 to 2. How many points should be given for each? The indicator of the norm - 2 points, a slight deviation up or down - 1 point, critical inconsistencies - 0 points. The transcript of the survey looks like this:

  • 4 or less points - the index shows an acute condition, the doctor must prescribe treatment, observe the patient regularly;
  • 5-7 points - an indicator of oxygen starvation;
  • 8-10 - the child is fine.

Video: what is fetal CTG during pregnancy

881

Why do CTG during pregnancy and what shows what the norm is. 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, in order to give birth to a healthy child, a woman simply has 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.

  1. 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.
  2. 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.
  3. 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.

Pregnancy is the happiest period in a woman's life. At this time, expectant mothers should monitor their lifestyle and health with increased attention, as they are also responsible for the health of the baby. To control the development of the fetus, various methods of laboratory and functional diagnostics are used. Thanks to a comprehensive examination of the body, the doctor receives a complete picture of the state of health. An informative diagnostic method is cardiotocography or CTG during pregnancy, but effectiveness is achieved only with proper preparation for the procedure.

Cardiotocography is an ultrasound examination method performed to assess the functioning of the fetal heart and the frequency of its contractions. CTG does not apply to mandatory procedures prescribed during pregnancy. As a rule, cardiotography is performed when abnormalities are detected according to the results of analyzes and ultrasound. Fetal CTG makes it possible to obtain data on the activity and work of the child's cardiac system, as well as on the frequency of uterine contractions. With the help of the examination, it is possible to detect or exclude the following pathological disorders:

  • excessive or insufficient accumulation of amniotic fluid;
  • hypoxia (oxygen starvation) of the fetus;
  • premature aging of the placenta;
  • anomalies (malformations) of the development of the cardiovascular system of the child.

The most optimal period for cardiotography is considered the last trimester of pregnancy. Until this time, the child's organs are not fully developed and formed, respectively, it is possible that the results will be unreliable. If there is evidence, the doctor may refer the patient to CTG at an earlier date. Cardiography is not an obligatory method of examination and, with the correct course of pregnancy, it is not necessary to conduct it. If there are pathological disorders determined using other diagnostic methods, then CTG is prescribed without fail, up to daily monitoring.

Rules for preparing for CTG

To obtain reliable results of cardiotography, it is necessary to follow the recommendations of the doctor, since the accuracy of the examination depends on this. When referring to diagnostics, the doctor always tells and gives recommendations on how to prepare for CTG. The main requirement for cardiotography is the activity of the fetus. Preparation for CTG is, first of all, that the child needs to be awakened. To wake up the baby, you can quickly walk, tickle the abdomen, make a few smooth jumps in place.

In the morning before the diagnosis, a woman needs to eat a light breakfast. It will effectively affect the activity of the fetus if the mother ate bitter chocolate before the examination. Before going to the office, you need to go to the toilet. The examination takes a long time, and the natural urge to urinate can make it difficult to be still. The emotional mood of a woman is also important, therefore, before the examination, one should not be afraid, think about negative events and problems. During the diagnosis, the patient is forbidden to talk and move.

The cardiogram lasts a minimum of 30 minutes, usually approximately 1 hour. Therefore, in order not to distort the results of the examination and reliably record data on the functioning of the heart and uterine contractions, you need to take a comfortable position. If deviations are found in the diagnostic process, but the woman does not complain about the state of health, then CTG is required to be repeated. A control examination is necessary in order to exclude the child's sleep phase and the influence of external factors. There is always the possibility of getting erroneous results.

The norm and interpretation of the results of CTG

Cardiotocography involves the measurement and fixation of several indicators at the same time, allowing you to get a complete picture of the condition of the fetus. If the developmental abnormalities detected during the diagnosis are dangerous for the child and the woman, then a decision may be made to stimulate labor, or to perform a caesarean section on an emergency basis. The normal CTG parameters are as follows:

  • contractile activity of the uterus - a duration of at least 30 seconds and no more than 15% of the number of contractions of the baby's heart;
  • acceleration - 2 or more in 10 minutes;
  • decelerations - rare, shallow, single and short;
  • basal rhythm - in the active phase below 190 beats / min, at rest 110-160 beats for the same period of time;
  • heart rate variability - from 5 to 25 beats / min.

Only the results of CTG are not enough to make a diagnosis. The data obtained during cardiotocography serve as auxiliary information, and additional analyzes and examinations are required to verify pathological disorders. The CTG results are reflected on the tape in the form of a line showing the child's heartbeat, and to assess the state of the system, its drops and height are measured.

Cardiotocography is deciphered on a 10-point scale, comparing several indicators at the same time. Each criterion is assigned from 0 to 2 points.

If the CTG result is 9 or more points, then this indicates the correct development of the fetus. A slight hypoxia is suspected if 6-8 points are obtained during decoding, and in this case, a second diagnosis is required. A score below 5 is typical for serious deviations (hypoxia, arrhythmia) and an additional examination is necessary. If suspicions are confirmed, an emergency delivery may be performed.

Cardiotocography is an absolutely safe procedure for both the fetus and the expectant mother.. If diagnostics are prescribed, then you can not worry about the harmful effects and negative consequences, even if repeated examinations are necessary. The main thing that is required from the expectant mother is to follow the doctor's recommendations before the procedure. The rules for preparing for CTG during pregnancy are simple and mainly consist in waking up the baby before the examination. If, according to the diagnostic results, deviations from the norm are found, there is no need to panic. To confirm the diagnosis, a second examination is required, as well as additional diagnostic methods.