Handbook of CTG Interpretation

From Patterns to Physiology

Edwin Chandraharan

• Publisher: Cambridge University Press
• Year: 2017
• Print ISBN:
  9781107485501
• eBook ISBN:
  9781316818244
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

This book promotes an evidence-based paradigm of fetal heart rate monitoring during labour, with a move away from the traditional 'pattern-based' interpretation to physiology-based interpretation. Chapters are presented in a systematic and accessible format, covering topics such as non-hypoxic causes of fetal brain injury, pre-existing hypoxia, types of intrapartum hypoxia, erroneous monitoring of maternal heart rate, fetal scalp blood sampling and fetal ECG (STAN), intermittent auscultation and medico-legal issues. Sections on 'pearls' and 'pitfalls' highlight good practice and common errors to promote best practice. End-of-chapter exercises allow the reader to engage with the theory and test their knowledge of key areas. This is a highly practical manual aimed at obstetricians and midwives, particularly those undergoing CTG training. The book will also be very useful to midwifery and medical students and to all those involved in multiprofessional intrapartum care.

Table of contents

• Cover
• Half-title
• Title page
• Copyright information
• Dedication
• Table of contents
• List of contributors
• Preface
• Acknowledgements
• Glossary
• 1 ‘An Eye Opener’: Perils of CTG Misinterpretation
• 2 Fetal Oxygenation
• 3 Physiology of Fetal Heart Rate Control and Types of Intrapartum Hypoxia
• 4 Understanding the CTG
• 5 Applying Fetal Physiology to Interpret CTG Traces
• 6 Avoiding Errors
• 7 Antenatal Cardiotocography
• 8 Intermittent (Intelligent) Auscultation in the Low-Risk Setting
• 9 Current Scientific Evidence on CTG
• 10 Role of Uterine Contractions and Intrapartum Reoxygenation Ratio
• 11 Intrapartum Monitoring of a Preterm Fetus
• 12 Role of Chorioamnionitis and Infection
• 13 Meconium
• 14 Intrapartum Bleeding
• 15 Labour with a Uterine Scar
• 16 Impact of Maternal Environment on Fetal Heart Rate
• 17 Use of CTG with Induction and Augmentation of Labour
• 18 Recognition of Chronic Hypoxia and the Preterminal Cardiotocograph
• 19 Unusual Fetal Heart Rate Patterns
• 20 Intrauterine Resuscitation
• 21 Management of Prolonged Decelerations and Bradycardia
• 22 ST-Analyser (STAN)
• 23 ST-Analyser
• 24 Role of a Computerized CTG
• 25 Peripheral Tests of Fetal Well-being
• 26 Operative Interventions for Fetal Compromise
• 27 Nonhypoxic Causes of CTG Changes
• 28 Neonatal Implications of Intrapartum Fetal Hypoxia
• 29 Role of the Anaesthetist in the Management of Fetal Compromise during Labour
• 30 Medico-legal Issues with CTG
• 31 Ensuring Competency in Intrapartum Fetal Monitoring
• 32 Physiology-Based CTG Training
• Appendix: Rational Use of FIGO Guidelines in Clinical Practice
• Answers to Exercises
• Index