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Criteria of Normal Fetal Heart Rate (FHR)

This document discusses the criteria for normal fetal heart rate (FHR) on a cardiotocography (CTG) including the baseline rate and variability. It also describes potential causes for abnormalities in FHR such as tachycardia, bradycardia, reduced variability, sinusoidal patterns, and different types of decelerations. Specific concerns that warrant intervention like a sinusoidal pattern or prolonged decelerations are highlighted. The document provides clinicians with guidance on interpreting CTG readings and understanding the clinical significance of any atypical findings.

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عمر احمد شاكر
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56 views

Criteria of Normal Fetal Heart Rate (FHR)

This document discusses the criteria for normal fetal heart rate (FHR) on a cardiotocography (CTG) including the baseline rate and variability. It also describes potential causes for abnormalities in FHR such as tachycardia, bradycardia, reduced variability, sinusoidal patterns, and different types of decelerations. Specific concerns that warrant intervention like a sinusoidal pattern or prolonged decelerations are highlighted. The document provides clinicians with guidance on interpreting CTG readings and understanding the clinical significance of any atypical findings.

Uploaded by

عمر احمد شاكر
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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CTG

Criteria of normal Fetal Heart rate (FHR)


 baseline heart rate of between 110 and 160 bpm
 variability of between 5 and 25 bpm
 accelerations (a transient increase in FHR of at least 15 bpm lasting at least 15
seconds)
 the absence of decelerations (transient decrease in the FHR of 15 bpm or more)

Figure 1 normal CTG


Fetal tachycardia: DDx :
 Fetal hypoxia
 Chorioamnionitis
 Hyperthyroidism
 Fetal or maternal anaemia
 Fetal tachyarrhythmia
Fetal bradycardia
It is common to have a baseline heart rate of between 100-120 bpm in the following
situations:

 Postdate gestation
 Occiput posterior or transverse presentations
Variability

Reduced variability : causes are:


 Fetal sleeping: this should last no longer than 40 minutes (this is the most
common cause).
 Fetal acidosis (due to hypoxia): more likely if late decelerations are also present.
 Fetal tachycardia
 Drugs: opiates, benzodiazepines, methyldopa and magnesium sulphate.
 Prematurity: variability is reduced at earlier gestation (<28 weeks).
 Congenital heart abnormalities
Sinusoidal pattern
A sinusoidal CTG pattern has the following characteristics:

 A smooth, regular, wave-like pattern


 Frequency of around 2-5 cycles a minute
 Stable baseline rate around 120-160bpm
 No beat to beat variability

A sinusoidal pattern usually indicates one or more of the following:

 Severe fetal hypoxia


 Severe fetal anaemia
 Fetal/maternal haemorrhage

Immediate C-section is indicated for this kind of pattern.


Accelerations

Decelerations

Early deceleration
Early decelerations start when the uterine contraction begins and recover when uterine
contraction stops. This is due to increased fetal intracranial pressure causing increased
vagal tone.
This type of deceleration is, therefore, considered to be physiological and not
pathological
Late deceleration
This type of deceleration indicates there is uteroplacental insufficiency , which caused
by:

 Maternal hypotension
 Pre-eclampsia
 Uterine hyperstimulation
Variable deceleration
usually caused by umbilical cord compression
Prolonged deceleration
deceleration that lasts more than 3 minutes

causes:

 Prolonged cord compression


 Cord prolapse
 Epidural and spinal anaesthesia
 Maternal seizures
 Rapid fetal descent

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