Recognising Fetal Compromise in the Cardiograph during the Antenatal Period: Pearls and Pitfalls

Susana Pereira; Caron Ingram; Neerja Gupta; Mandeep Singh; Edwin Chandraharan

doi:10.9734/ajmah/2020/v18i930238

Research Article Open access CC BY 4.0

Recognising Fetal Compromise in the Cardiograph during the Antenatal Period: Pearls and Pitfalls

Susana Pereira, Caron Ingram, Neerja Gupta, Mandeep Singh, Edwin Chandraharan

Asian Journal of Medicine and Health · pp. 72–83 · Published 3 Sep 2020

10.9734/ajmah/2020/v18i930238

Abstract

There are several national and international guidelines to aid the interpretation of the cardiotocograph (CTG) trace during labour. These guidelines are based on assessing changes in the fetal heart rate (i.e. cardiograph) in response to mechanical and hypoxic stresses during labour secondary to ongoing frequency, duration and strength of uterine contractions (i.e. tocograph). However, during the antenatal period, uterine contractions are absent, and therefore, these intrapartum CTG guidelines cannot be used to reliably identify fetuses at risk of compromise. Computerised analysis of CTG using the Dawes-Redman Criteria could be used to detect fetal compromise. However, clinicians should be aware of the multiple pathways of fetal damage (i.e. inflammation, infection, intrauterine fetal stroke, chronic fetal anaemia, acute feto-maternal haemorrhage and fetal cardiac or neurological disorders) which can cause changes on the CTG trace which may not be recognised by using CTG guidelines.

Antenatal cardiograph computerised CTG short term variability sinusoidal pattern Dawes-Redman Criteria Chronic Hypoxia

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Susana Pereira, Caron Ingram, Neerja Gupta, Mandeep Singh, Edwin Chandraharan (2020). Recognising Fetal Compromise in the Cardiograph during the Antenatal Period: Pearls and Pitfalls. Asian Journal of Medicine and Health , 72–83. https://doi.org/10.9734/ajmah/2020/v18i930238

Affiliations

Susana Pereira — Department of Fetal Medicine, Kingston Hospital NHS Foundation Trust, Galsworthy Road Kingston Upon Thames, Surrey KT2 7QB, UK.
Caron Ingram — Fetal Surveillance Midwife, Basildon University Hospital, Nethermayne, Basildon Essex, SS16 5NL, UK.
Neerja Gupta — Basildon University Hospital, Nethermayne, Basildon, Essex, SS16 5N, UK.
Mandeep Singh — Department of Feto-Maternal Medicine, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea, Southend-on-Sea, Westcliff-on-Sea, SS0 0RY, England.
Edwin Chandraharan — Global Academy of Medical Education and Training, Office 4, 219 Kensington High Street, Kensington, London, England.

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