1. Purpose
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Cardiotocography (CTG) or electronic fetal monitoring (EFM) is the most widely used technique for assessing fetal wellbeing in labour in the developed world. The primary purpose of fetal surveillance by CTG is to prevent adverse fetal outcomes2.
This document provides guidelines for clinicians in CTG interpretation and response to the CTG pattern by defining a standardized process of interpretation, documentation and management of cardiotocographs (CTG), in particular where variations from ‘normal’ occur.
CTGs have a high degree of sensitivity but a low level of specificity which means that they are very good at telling us which fetuses are well but are poor at identifying which fetuses are unwell. The differences in individual fetal responses to a decrease in oxygen (and therefore differences in heart rate changes) mean that the positive predictive value of CTG for adverse outcome is low and the negative predictive value high. The increased intervention rates associated with EFM can be reduced with the use of fetal blood sampling (FBS). This guideline can be used in conjunction with the guideline CPG Fetal Blood Sampling.
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Guideline
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To download the complete Clinical Practice Guideline select the following link:
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Labour: Cardiotocograph (CTG) Interpretation and Response (pdf 525 kb)
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Published: 2 December 2011
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Royal Women's Hospital Clinical Practice Guidelines (CPGs) are intended to provide guidance to health care professionals, based on a thorough evaluation of research evidence, on the practical assessment and management of specific clinical issues or situations. The guidelines allow some flexibility on the part of the health care professional based on the needs of the specific patient for whom they are caring.
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