Cardiotocography is an important study of a very small human heart and helps to identify pathologies at an early stage, to begin to correct problems. What does CTG of the fetus show, how to decipher the tests and how to determine whether 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 in that it allows you to identify abnormalities at an early stage. Doctors, using an apparatus for listening to the fetal heartbeat, determine this procedure, which is mandatory for a future mother, like ultrasound and dopplerometry.

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

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

In what cases is the fetal cardiotocography indicated

Heart palpitations and uterine contractions on CTG are checked in such cases:

1. If the condition of the baby and mother is normal, then CTG with a normal pregnancy is done once. If the recording recorded pathological changes, rewriting is assigned. The procedure is carried out from 30 weeks of pregnancy.
2. If past pregnancies proceeded unsuccessfully (child's death in utero, genetic and chromosomal disorders).
3. Mom's feeling that something is wrong with the baby. Every mother already knows how the baby behaves in the womb. If there is a change in the regimen, activity of the child, then the pregnant woman should pay attention to this.
4. With the occurrence of acute diseases (flu, tonsillitis, acute respiratory viral infections), chronic infections in a pregnant woman and treatment on an outpatient basis or in a hospital.
5. With gestosis in a pregnant woman.
6. If a woman is subject to bad habits: during pregnancy smokes, takes alcohol or drugs.
7. In case the pregnant woman suffers from chronic diseases of the internal organs.
8. If pregnancy is delayed.

How long does fetal CTG do?

If the pregnancy proceeds normally, there are no complications, then CTG is recommended to be performed 1-2 times in the third trimester. If during the first studies any pathological changes are detected, an additional research procedure is prescribed. A verification procedure is carried out during childbirth in order to assess the complex general condition of the baby. During the fight, a CTG record is made, which assesses the condition of the child, and decisions are made on further delivery. This is especially true for babies with a cord entwined.

Why do CTGs are pregnant?

Using only this research method, you can not 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 entanglement. This condition is dangerous for the violation of the flow of oxygen from mother to child. Blood flow that is not restored on time can lead to a serious condition.
2. Irregular heartbeat of the fetus. This is a signal that there are abnormalities 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 allow the most correct labor activity. If the mother has pathologies that affect the fetus, then the woman is sent to a hospital, observed and recorded daily. If abnormalities are detected, the expectant mother is examined on an ultrasound scan and Dopplerography is performed. If the diagnosis is confirmed, then treatment is prescribed, in which CTG is done daily 1-2 times to assess the effectiveness of 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. For this, mom needs to eat something sweet, better chocolate before the procedure. A woman takes a lying or reclining position, is conveniently located. A pressure sensor (strain gauge) and an ultrasonic sensor are attached to the stomach. The first controls the contractions of the uterus, the second - the heartbeat of the fetus. Recording lasts 30-60 minutes.

Absolutely every woman during pregnancy is worried about how her baby is developing, is everything all right with him. Today, there are methods that allow a fairly reliable assessment of 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 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 activity of the fetus.

Diagnostics is carried out using two ultrasound sensors, one of which is strengthened on the abdomen of a pregnant woman, after determining the area of \u200b\u200bgood audibility of the child’s heartbeat.

It is intended for registration of cardiac activity of the fetus. The sensor receives an ultrasonic signal reflected from the child’s heart, which is then converted by the electronic system into an instantaneous heart rate. The second sensor is fixed on the abdomen in the uterine fundus. It records uterine contractions. To improve the transmission of ultrasonic waves, the sensors are treated with a special gel. Also, modern devices are equipped with a remote control, by clicking on the button of which, a pregnant woman can observe fetal movements.

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

What is CTG necessary for?

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

There is a clear correlation 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 termination, gestosis, then the results of CTG are most likely to be normal. If, with the well-being of the pregnant woman, suspicious CTG results are observed, then it is necessary to re-examine the patient after a week.

If a pregnant woman has found serious changes in her health condition, 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 32 weeks of pregnancy, since only by this time the maturation of neuromuscular impulses occurs, and the method becomes the most informative.

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

Also, by this time, the fetus establishes a cycle of activity and rest, which is of great importance for this study. When performing CTG during the resting period of the fetus, the results will always be positive, even if in fact there is a high degree of hypoxia. That is why the study should be conducted for at least 40 minutes. During this time, the fetus will necessarily 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 study. An uncomfortable position or vivid emotions can cause a more active movement of the fetus, which will lead to false results. Usually, during the procedure, a woman sits in a comfortable chair or lies on a couch on her side.

In order to understand how to decipher the CTG of the fetus, we will analyze in detail what parameters are used to evaluate it.

Basal Heart Rate

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

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

Lowering the basal level below normal (bradycardia) may be due to hypoxia, fetal heart defects, as well as decreased maternal blood pressure, hypoxemia, prolonged compression of the umbilical cord, 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, the nature of which emit low oscillations (deviation is less than three beats / min), medium (3-6 beats / min), high (amplitude more than 6 beats / min).

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

Particular attention in the analysis of cardiotocograms is given to slow oscillations. Depending on their amplitude, a monotonic 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 wave-like (from 11 to 25 beats / min) and a jumping type (amplitude above 25 bpm). An increase in the amplitude of oscillations can 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 nervous system of the fetus, the use of drugs, tranquilizers.

Acceleration

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

Deletion

Deceleration is the reduction in fetal heart rate by at least 15 beats / min for more than 15 seconds. The graph presents as significant depressions. Distinguish between early, late and variable decelerations. In addition, they are classified by amplitude as light with a decreased heart rate of up to 30 beats / min, moderate - 30 - 45 beats / min, and heavy - from 45 beats / min. Heart rate reduction can occur due to impaired placental blood flow, compression of the umbilical cord.

CTG of the fetus. Norm indicators

To assess the condition of the fetus, the World Health Organization has developed recommendations that indicate the minimum and maximum acceptable values \u200b\u200bfor each of the parameters. According to these recommendations, fetal CTG (normal for 33 weeks) should have the following meanings:

• Basal heart rate: 110-160 beats / min.
• Heart rate variability within 5-25 beats / min.
• Two or more accelerations in 10 minutes.
• Lack of deep decelerations.

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

Assessment of the condition of the fetus by points

Decipher the results of CTG on a 10-point system, evaluating each criterion from 0 to 2 points. For fetal CTG, the norm of 36 weeks, 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 urgent threats, it is necessary to repeat the CTG procedure in a week;

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

It must be remembered that even if the CTG of the fetus is 8 points or slightly lower, you do not need to be scared ahead of time. In this type of study, 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 baby is sleeping or awake. Experienced doctors, when decoding cardiotocograms, take into account factors such as weather conditions, the mood of the pregnant woman, and the level of glucose in the woman’s blood. If the CTG data are not normal, then the doctor will prescribe an additional examination. Typically, cardiotocography is performed twice in the third trimester of pregnancy, but in some cases more, for example, with multiple pregnancy, high blood pressure, the presence of infections, diabetes mellitus, unsatisfactory results of ultrasound examination, bleeding, premature contractions.

Possible errors in the interpretation of CTG data

1. The baby in the womb is in constant motion. Sometimes he can press the umbilical cord with his head, because of which blood flow in the vessels of the umbilical cord is disturbed for a short time, which affects the results of CTG. In this case, the cardiotocogram will have a pathological character with a good condition of the fetus.
2. 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 CTG.
3. With the development of pathology, the ability of tissues to absorb oxygen with its normal content in the blood may decrease, because of which the fetus does not react, and CTG will be normal, although it suffers due to a lack of oxygen.

Given all of the above, it should be understood that CTG of the fetus during pregnancy is a very important diagnostic method, but to obtain a complete picture of what is happening, CTG data must be compared with data from other studies. Today, ultrasound diagnostics and Dopplerometry are widely used.

Where can I do CTG of the fetus

CTGs are done free of charge in all antenatal clinics. You can conduct research in private medical centers, but for a fee.

Maternity hospitals also conduct cardiotocography 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 the tactics of childbirth.

Some expectant mothers are afraid to conduct various kinds of studies 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 good health!

When the expectant mother reaches the stage of fetal movement of the fetus, this is considered quite a good sign for the development of the child. Since it is practically impossible to immediately determine the state of the child by the factor of movement, that is why some research methods are used (CT, ultrasound, dopplerometry).

What is CTG of the fetus?

• Cardiotocography  - a method for determining during pregnancy the state of an incipient fetus, according to the components of the research of the ultrasonic signal and Doppler.
• Cardiotocogram gives the result immediately in paper form, and upon completion of the equipment, the specialist obstetrician-gynecologist determines the conclusion based on the information issued by the equipment.
• With CTG  register the fetal heartbeat, uterine contractions, the development of the baby in the mother’s womb. Allows you to monitor the activities of the heart during pregnancy or childbirth, in order to expand the diagnostic capabilities.
• Ultrasonic sensor  at a given frequency of 1.5-2.0 MHz, shows the functioning of the fetal heartbeat, the work is carried out on the Dopplerometric effect.
• CTG of the fetus during pregnancy  It helps to identify the flow of oxygen and nutrients to the baby, and also shows signs that adversely affect development, to further prevent them.
• Many future mothers are interestedHow long does CTG do? The answer to the question was that cardiotocography is usually prescribed from the thirtieth week of pregnancy and for nine months.
• In case of complications  during pregnancy, the specialist prescribes an additional examination. In the birth cycle, CTG is necessary to determine the condition of the fetus, as a result of which a decision is made on the delivery.

In this article you will find the norm.

Varieties of CTG devices

Evaluation of the performance of the heart in the fetus in the womb with cardiography can be examined in each medical institution. Basically, the doctor listens to the rhythm of the baby's heartbeat on an obstetric stethoscope. If necessary, or if dysfunction of the body is detected, cardiotocography is performed.

There are varieties of CTG:

Indications for cardiotocogram

This method is not contraindicated and completely harmless. CTG is assigned individually for each in different ways. After the water flows from the woman in labor, a diagnosis is made. During the birth process, recording occurs within half an hour or at the end of the birth process.

When conducting CTG adhere to special cases:

• Hypoxia, developmental delay;
• When using artificial means of stimulation during childbirth;
• Multiple pregnancy;
• A scar on the uterus with cesarean section or abortion;
• Existing severe diseases in a pregnant woman;
• Gestosis at a late date;
• Overexposure or prematurity of the baby.

The obtained information of the cardiotogram, their correct interpretation allows you to find out the condition of the fetus in the mother’s womb. During the birth procedure, CTG is used to reduce the risk of fetal death and various complications. CTG is considered the safest and most effective procedure.

How is the procedure performed?

The process is completely safe, but you need to prepare for it:

1. Before carrying out, you need to try to get enough sleep, no mood swings, feelings, frustrations, there should be only calm.
2. It’s best to eat a chocolate bar or something sweet.
3. A pregnant woman is lying down, a strain gauge and a sensor for an ultrasonic signal are attached to the stomach.
4. With a strain gauge, uterine contractility is monitored, and an ultrasound probe is responsible for the baby’s heartbeat, as a result of which the apparatus displays a graph of signals or heart rate in ribbon paper.

The duration of the procedure is carried out after 30 minutes or hours.

There are rare situations when the baby is sleeping in the mother’s womb, and therefore it’s very difficult to register the baby’s movements.

Remember that you should not wake the baby by touching or stroking the mother’s stomach. The study will show false information due to vibrations that will be displayed on the recording procedure itself. In any case, the procedure can be rescheduled to another day.

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It often happens that pregnant women can detect a violation of the state of the fetus by CTG. This procedure can be prescribed by a doctor as much as necessary, in order to identify the reasons for the further productive development of the fetus.

Shows the ability of the fetus to endure stress, its own movements, uterine contractions, and the difficulty of passing through the birth canal.

Normal performance

The procedure takes a lot of time from about half an hour to an hour.

The main indicators of fetal CTG are:

At the end of the procedure, fetal indicators are evaluated on a ten-point scale, after which CTG scores are summarized:

• from 0 to 4 points. Strongly manifested hypoxia of the fetus by CTG (lack of oxygen in the baby’s blood ) . Emergency delivery clearance is advisable.
• from 5 to 7 points. A small supply of oxygen to the fetus, but this is not life-threatening, it is necessary to undergo an additional CTG examination after two days.
• from 8 to 10 points. The normal condition of the child.

If in doubt, they are sent for re-examination of cardiotocography, since perhaps the baby in the womb was passive.

Explanation of indicators

Any pregnant woman can decrypt CTG, but without a doctor one cannot draw a conclusion about the results.

Each decoding of CTG of the fetus by weeks indicates the main indicators:

• at week 34 - basal rhythm of heart contraction from 120 to 160 beats per minute, rate of variability from 25 to 40 beats per minute of the fetus.
• at week 36  - The characteristic of the basal rhythm remains normal as well. Variability ranges from 10-25. As a result, the total score is up to 8.

Indicators can constantly deviate from the norm, so do not immediately panic. If you need a second study, then there is nothing to worry about, since next time the indicators are normalizing.

It is important not to worry before the procedure and during. Your baby’s health is above all.

Reasons for deviation of indicators from the norm

Deviations of indicators from the norm are not the reason for making a 100% diagnosis. CTG gives information about the well-being of the child in the womb at a certain time.

If it happened that during the procedure everything was normal, but then there were jumps on the graph, showing deviations, then a second passage of cardiotocography, ultrasound and dopplerography are prescribed.

In the case of a poor CTG result, if available:

1. Basal rhythm up to 190 beats / min .;
2. Variable rhythm up to 4 beats / min .;
3. Acceleration deficiency;
4. Slow deceleration.

If there is a very poor result of CTG and other studies in a pregnant woman, the doctor sends a Caesarean section or an artificial birth call. Subsequently, the birth permit of CTG is carried out many times. The need for cardiotocography is to determine the risk to the health of the fetus.

Errors in the assessment of CTG

Errors or crashes in the program obtained with CTG, as in any other technique, are quite acceptable:

• Specialists  Despite the fact that there are reasons leading to errors, in addition to the results of CTG, they are also guided by the conclusions made by other research methods, and only make a decision in the end.
• In this procedure  the reaction of the autonomic nervous system to pathogens is laid. This change in the heart rate of the fetus shows a characteristic of the processes in the developing fetus.
• Let's say when observing  hypoxia in CTG, it happens that the fetus experiences oxygen starvation, but has a quick adaptation to this condition and then CTG will not be able to show a pathological condition, despite the fact that there is hypoxia.
• In another situation  the right amount of oxygen enters the bloodstream, but is poorly absorbed, and also does not affect the heart's performance and schedule.

That is why CTG is just an additional research procedure, but an important diagnostic tool for identifying pathologies in the mother’s womb.

And one should not do one CTG, but rather a few, as errors in the procedure can always be. The diagnosis is made only when all types of examinations have really been passed.

What to do with a poor CTG result?

Still, it would be incorrect to call the result bad, rather uninformative in connection with the current circumstances and possible factors affecting the condition of the fetus. If there is doubt in the CTG information received on the condition of the fetus, it is simply necessary to undergo additional cardiotocography.

The cardiotocogram device does not act badly on the mother's body and does not contribute to the manifestation of any violations on the fetus itself and its condition. The method of cardiotocography is based on ultrasound exposure, and in no case does harm to pregnant women.

• CTG, although it is considered a wonderful device, but its benefit is to identify possible signs of deviations in the health of the child and mother.
• Say that basal heart rate  (BFSS) of the fetus should be recorded less than 120 or 160 beats / min. If necessary, you will have to go through a consultation with an obstetrician-gynecologist. Each term has its own research indicator.
• Before birth  CTG shows new contractions present in normal. Speaking of contractions, this is the so-called uterine reaction to fetal movement or uterine contractions.
• For a long time,  accordingly, pains become more frequent. The contractions of the heart on the graph are displayed as take-off and falling curved lines.
• Doctor examines  minimum and maximum values \u200b\u200bfor determining the average value and the number of teeth. Small teeth indicate deviations from the basal rhythm, in which the amount should not normally be exceeded to 6 pieces at 32 and 39 weeks. The height of the teeth is normal from 11 to 25 beats / min.
• Allowed height  from 0 to 10 beats / min, if only early pregnancy, since the fetus is calm at this time. An indicator in excess of 25 strokes indicates the presence of entwined fetal umbilical cord.

Procedure cost

The process of conducting CTG is free in Russian budgetary medical institutions.

In private institutions, the cost depends on the quality of the cardiotogram and the level of service, also takes into account the composition and recall of the institution. The cost of one CTG procedure in Russian clinics varies within from 800 to 1200 rubles.

Total

• CTG is believed to be effective  a diagnostic device that helps to identify a normal or pathological condition in the fetus. Carries out the diagnosis of heart disease, the characteristic features of childbirth and the condition of the child.
• The procedure is painless  and safe for pregnant. Takes readings of contractions and fixes all fetal movements. The method is as highly effective as ever and provides information in full, the information produced is issued in paper form in the form of graphs.
•   If in the womb  If there are two fruits, then two cardiotocogram sensors are connected.
• Possible reliable determination  heart rate fluctuations, rhythm, frequency, heart contractions, sudden contractions or other fetal reactions.

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

Such examinations can be safely attributed cardiotocography  (abbreviated CTG), today this method is one of the most valuable, it allows you to determine the condition 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, CTG fetus began to be used recently.just a couple of years ago. Most often, it is carried out in combination with dopplerometry and ultrasound, this allows you to accurately find out how the child feels.

What is the period of CTG?

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

This is because fetal nerve and muscle impulses mature at a later date, that is, at 32 weeks. Also, at this point, the child is establishing 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 any deviations (for example, a high degree).

therefore 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 gynecologist every time calculates the beats of a baby’s heart  using a special stethoscope. The method allows you to study contractions of the heart muscle - how frequent, normal or too rare.

Based on this, the doctor concludes that the child is in a condition and does not feel discomfort. In case of abnormalities, the pregnant woman is immediately sent for cardiotocography, it will allow you to more accurately diagnose.

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

During the survey 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 testimonies will be reflected on paper.

CTG shows normal results in 95 percent of 100 womenwhose 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 condition of the baby and the well-being of the mother, scientists have identified a long time. In the event that the study shows poor results, and the pregnant woman feels great and there are no changes for the worse, she should prescribe a follow-up examination in a week.

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

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

What is the norm?

All the results of CTG are reflected on the tape in the form of a curved line, with its help the doctor can tell you exactly 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 smooth;
• rate of rhythm variability  (deviation height) should be from 5 to 25 beats per minute;
• slow heart rate  (de-acceleration) should be as rare as possible, their depth should be no more than 15 beats per minute. There should not 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 strokes;
• less than one is normal fetal rate;
• uterine activity (tokogram) should be no more than 15 percent in relation to the baby’s heart rate within 30 seconds;
• all of the above studies are evaluated on a 10-point system, as a result set from 9 to 12 indicates the normal condition of the child.

Explanation of indicators

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

Only an obstetrician-gynecologist can decrypt 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 is a good doctor takes into account when decoding.

Most often, the gynecologist does not explain to the expectant mother what this or that indicator stands for, since without additional preparation it is difficult to understand them.

Therefore, the doctor simply reports whether there are deviations or not. Below are deciphers of each term, this will allow you to get at least a general idea of \u200b\u200bthe results and you will know what indicator can be considered bad CTG during pregnancy.

Each criterion gets a rating from 0 to 2, all points are calculated, and we get a common indicator, which indicates the following:

• 9-12 points showthat everything is in order in the child, no deviations were found. The doctor may advise you to observe further;
• 6-8 points showthat the child develops moderate hypoxia (oxygen starvation). To clarify the result, the doctor prescribes a second study every other day;
• 5 or less points indicatethat the life of the fetus is in danger, since he has severe oxygen starvation. In some cases, urgent treatment is prescribed, sometimes the pregnant woman is sent for unscheduled.

Key indicators of fetal cardiac activity:

1. Basal rhythm  (the frequency with which the heart beats or heart rate) - if the child is in a calm state, beats should be considered as deviations per minute of less than 110 and more than 160. If the baby is moving, beats of less than 130 and more than 190 per minute are not normal.
2. Heart rate or variability  - the average number of deviations from the norm is calculated. If it is less than five or more than 25 beats per minute - this is a deviation.
3. Acceleration  (moments of acceleration of heart contractions) - on the graph they are shown in the form of teeth. Deviation is considered less than two peaks in 10 minutes of active movement of the fetus.
4. Deaeration (i.e. slowing down contractions) - on the graph it is shown with teeth down. In the normal state, it is absent, but can be fast and shallow or slow (which is the worst).
5. Fetal score (PSP)  - small violations are indicated from one to two, and serious deviations - more than two.

If even one indicator exceeds or does not reach the norm, this may presumably correspond to violations in the child.

Is it harmful to conduct CTG for a pregnant woman?

Cardiotocography - absolutely safe examinationShe has no contraindications. Expectant mothers are very worried about the health of the babies and therefore they perceive each study with caution, in this case it can be stated with confidence that CTG is completely harmless.

During the procedure, the pregnant woman does not experience pain, she is not injected with drugs, her skin is not injured or punctured, there is no need to give injections and the like.

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

Do not refuse to hold it, because the timely detection of deviations and violations will save the future baby using various procedures.

Where can I do CTG?

Free cardiotocography is most often performed in antenatal clinics.  or nearby maternity hospitals, ask a gynecologist about this.

If someone is not happy 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 in the help desk of the city.

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

If these studies show poor resultsthen the doctor can deliver hypoxia and prescribe the correct and effective treatment.

This is especially important in the last two months of pregnancy, at this time the baby was almost formed and for a comfortable existence it needs a sufficient amount of oxygen. Do not forget about it and comply with all the requirements of the gynecologist on time.

Registration of changes in the number of fetal heart contractions simultaneously with changes in contractile activity of the uterus and fetal movements on paper using electronic equipment was called cardiotocography (CTG).

What is CTG?

CTG is the most commonly used and affordable method of monitoring the condition of the fetus along with ultrasound (ultrasound) and is a continuous simultaneous recording of the heart rate of the fetus (heart rate) - cardiotachogram and uterine tone - tokogram.

Sensor Location

For CTG during pregnancy, a special apparatus is used - a cardiomonitor. Cardiac activity of the fetus is recorded with a special ultrasonic sensor. It is strengthened on the anterior abdominal wall of a pregnant woman in the area of \u200b\u200bthe best audibility of the fetal heart sounds, which is previously determined using a conventional obstetric stethoscope.

And to measure the tone of the uterus, a strain gauge sensor is used (to measure the strength of contractions and spontaneous contractions of the uterus). During the fight, the pressure on the load cell rises in proportion to the intrauterine device. It is converted by the sensor into an electrical impulse and is recorded as a curve on a moving paper tape.

A cardiotocogram is a paper tape (moving at a speed of 1-3 cm / min.) With two curves combined in time. One of them (upper curve) displays the heart rate (HR), and the other - uterine activity (uterine contractions).

Earlier, during CTG, pregnant women themselves noted the movements of their baby in the abdomen by pressing a button on the device. At the same time, a mark appeared on the graph, allowing you to compare the change in the heart rate of the fetus and its motor activity. The latest models of cardiomonitors are equipped with sensors that continuously record the intensity and duration of fetal movements.