Cardiotocography

Labour is a stressful event for both the fetus and the mother. Intrapartum hypoxia is detrimental to the fetus and it is of utmost importance to recognize fetal hypoxia or acidosis during labour in order to carry out necessary interventions. Cardiotocography (CTG) is an investigation which monitors the fetal heart and maternal contractions. It is the practice of many clinicians to follow guidelines and recognize CTG patterns. However mere adherence to pattern recognition has led to misinterpretation of CTG traces. This has resulted in missing hypoxic events and also in performing unnecessary interventions. Understanding the physiology of fetal oxygenation and physiological basis of intrapartum hypoxia carries a significant amount of weight in accurate interpretation of CTG traces. In this module we will be focusing on physiology based CTG interpretation and how to incorporate the learnt physiology in the management.