Interpreting cardiotocograph tracings
Classifying and defining each feature on the tracing leads to easier interpretation and diagnosis
- By: Sam Dobson, Jessica Keeley, Andrew Simm
At some stage in your medical training you will observe normal labour and witness or assist in a birth. In these situations you will come across the intrapartum fetal monitor and the cardiotocograph (CTG). You might be asked to classify and interpret a CTG tracing at the bedside, on a ward round, in a CTG meeting, or even in an examination. Although not used routinely in an antenatal setting, a CTG can be used to ensure fetal wellbeing—for example, where reduced fetal movements are suspected.1
Correct classification and interpretation of the CTG tracing is an important part of assessing fetal wellbeing, with poor interpretation being the most common avoidable contributor to intrapartum death.2 This is because misinterpretation can lead to poor management plans, which may result in adverse outcomes such as cerebral palsy, hypoxic ischaemic encephalopathy, or perinatal death.
This article presents the basics of intrapartum fetal monitoring, classification, and