Cardiotocography + Labour Induction

indications fetal monitoring by cardiotocography

• gestational htn, preeclampsia, vasc diseases

• premature labour, IUGR

• prolonged labour, vaginal bleeding, oxytocin use

cardiotocography: The frequency of contractions is counted in the unit of time of

10min

characteristics of uterine contractile activity on cardiotocography

• frequency

• amplitude (max intensity)

• uterine basal tone (p bw contractions)

normal fetal conditions on cardiotocography

BHR between 120 and 160 bpm, a variability between 5 and 15 (25) bpm, and periodic accelerations

excess uterine activity can be caused by

• oxytocin or PGs

• passage meconium in amiotic fluid

• placental abruption

FHR on cardiotocography at 7w, 10w and after 32w

70-70

180

120-160

normal track of FHR characteristics

• basal fhr 110-150

• periodic accelerations

• normal variability bw 5-25bpm

methods for intrapartum fetal monitoring

cardiotocography

blood samples w/ pH

CTG and fetal ECG

computerized analysis CTG

normal amount contractions in 10m in cardiotocography

3-5

drugs for induction labour

oxytocin

PGs

indications labour induction

postdates

oligohydramnios

IUGR

macrosomia

COs induced labour

<18y

CO to vaginal birth

multiple pregnancy

placenta previa

score to establish chances of inducing labour

bishop

specific indication oxytocin for labour induction

oxytocin - mature cervix, bishop score >9

SEs labour induction

uterine tachysystolia (>5 contractions in 10m), hypertonia (contractions >2min)

hyperstimulation sd

placental abruption