CTG contractions: what they look like, transcript, photo

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

During pregnancy, you have to undergo many different studies. Some of them are unusual and new, moreover, they are carried out at different periods of bearing a baby. But the main goal of any diagnosis is to monitor the he alth of the mother and her baby. Particular attention is paid to these moments during the onset of childbirth. Thanks to modern technologies, during ultrasound, you can take a photo; on CTG, contractions are recorded on tape paper in the form of a diagram. The specialist easily deciphers the information received and can respond in a timely manner to any changes that occur at the moment.

Real contractions

False and true contractions may occur during pregnancy. There are several ways to determine what a woman is really experiencing. Braxton-Hicks contractions (training) occur at the beginning of the third trimester and indicate that in this way the body begins to prepare for the upcoming labor activity. pregnant mayfeel how the stomach tenses at times, while the spasms are painless or cause minor discomfort. Everything returns to normal after taking a warm bath or shower, antispasmodics, such as No-shpa, Papaverine, rest / sleep.

Starting from the 32nd week of pregnancy, a woman can be referred for CTG. What do training bouts look like on the transcript of the readings? Uterine contractions are weakly expressed, doctors note this fact by studying digital indicators. On the tape, the intensity of the contraction will be below 110 beats per minute. At the same time, a pregnant woman may note that her baby is showing increased activity.

How to understand that labor has begun?

The onset of labor does not immediately become intense and painful. Many women do not sleep at all during the first phase of cervical dilatation. If a pregnant woman is under the supervision of a doctor before giving birth, then what the contractions look like on CTG, she can see with her own eyes more than once. Women admitted to the maternity hospital or perinatal center in the second or third phase, as a rule, no longer pay attention to the sensor, which can be urgently connected to it. Contractions at this stage become frequent, regular and painful. No painkillers help, and even a warm shower saves only for a while. These are true contractions.

Why do you need to control the intensity of uterine contractions

The baby moves towards the birth canal and its movements coincide with the contractions of the muscles of the body of the uterus. What does CTG look like during contractions and why is thismeasurement? The main task is to monitor the fetal heartbeat. During a contraction, the intensity of the heartbeat increases, which indicates that the process is proceeding naturally. But as soon as the sensor detects a decrease in heart rate, this serves as an urgent signal for the doctor to take emergency measures. If the situation is not corrected, then the question may arise about an emergency caesarean section.

What is CTG?

Cardiotocograph refers to the methods of ultrasound examination. The results of his research are lined up in a graphic image that is displayed on a paper tape. The method is completely painless, easy to use and extremely informative. Doctors resort to it not only during the period of prenatal diagnosis of the condition of the mother and child, but also during the period when the woman began to have real contractions. On the CTG, the tape is divided into two halves:

• The number of fetal heart beats per minute is recorded in its upper part.
• At the bottom - contractions are displayed. If the uterus is at rest, it keeps within the lower border. As soon as the uterus contracts, the curve rises up.

According to the results of the cardiotocography, the doctor may also diagnose signs of fetal asphyxia, abnormalities in terms of neurology, heart function, or cord entanglement.

How it works

The measurement is taken when the woman is lying on her side or back. She must take a comfortable position, otherwise the information received may be distorted. In the first phase of childbirth,when the frequency and intensity of the contractions do not yet cause severe discomfort, the woman in labor is asked to press the cardiotocograph button while the baby is moving. For the doctor, the obtained indicators are very important, as he can assess the situation regarding the child's well-being at the moment.

A sensor is attached to the belly of a pregnant woman by a doctor or nurse, fixed on the body with a belt. The device sends out ultrasonic waves that make their way to the baby's heart and back. In addition, the strain gauge determines the frequency of uterine contractions (frequency and duration of contractions). Inside the cardiotocograph, the received data is combined, which is displayed as a graph on the tape.

Doctors use special terms - histogram and tachogram. Below you can see a photo of how the contractions look on the CTG.

The second part of the graph shows the fetal heart rate. At the same time, the number of beats per minute is visible on the ordinate axis, and the number of beats per minute is visible on the abscissa axis. If the curve “went” up, it means that the baby’s heart began to beat faster, if it went down, it means that the heartbeat slowed down. Modern and more advanced models allow you to determine the motor activity of the child inside the womb.

Types of cardiotocographs

Depending on the integrity of the placenta, it is customary to distinguish between two types of CTG. What do contractions look like at different stages of labor or in a situation where they are of a training nature? This question should be moreexcite medical personnel than a pregnant woman. However, it will be useful to understand what the essence of the study is and why it is assigned. In fact, everything is quite simple and clear, so you can figure it out once, more for personal development.

If the integrity of the fetal bladder is damaged, the doctor can use internal cardiotocography. The doctor inserts a spiral needle electrode into the fetal presentation area and records the heartbeat. The intensity of contractions is determined using a special sensor that is inserted into the body of the uterus. In this way, the doctor can obtain information regarding the status of intrauterine pressure.

If the fetal bladder is intact, then the sensor is attached externally. To obtain more accurate data, the obstetrician determines the source of the clearest fetal heart signal. The strain gauge is attached to the fundus of the uterus.

Survey duration

When carrying out prenatal diagnosis, a pregnant woman is recommended to undergo a cardiotocographic study starting from the third trimester. Its duration is from 30 minutes to an hour. It happens that CTG shows contractions that go unnoticed by a woman. As a rule, they are rare and short-lived. More reminiscent of tone than true contractions. If during pregnancy a woman feels well, has no history of preeclampsia, pathologies, other diseases that may affect the he alth of the fetus, then the effectiveness is very high. According to medical statistics, 95% of 100 that received informationwill show the true picture of the baby's well-being.

What is normal

To know what the indicators should be within the normal range, it is necessary for the doctor to be able to give an objective interpretation of the data received. On the tape, you can see not only how contractions look on CTG, but also the presence of deviations in the baby's he alth. What the doctor pays attention to:

• Deceleration or decrease in the number of heartbeats. Their depth normally does not exceed fifteen beats per minute. A he althy heart should not have slow decelerations.
• Heart rate ranging from 100 to 160 per minute, if the baby is awake and active - 130-190. Deviations in heart rate variability from 5 to 25 beats per minute are allowed, normally it should be even. Within half an hour, the number of fetal movements should be at least two.
• Tokogram (activity of the body of the uterus) is evaluated along with the baby's heart rate (HR). As a guideline, a time interval of 30 seconds is taken, which is evaluated by the doctor. The tokogram normally should not exceed the heart rate by more than 15%.

Results in points

During cardiotocography, each indicator of the state of the fetus and uterus receives its assessment in points (Fischer's method). If the indicators appear at the lower limit, then 1 point is assigned for each item. Within the average value - 2 points each. Three points for each indicator are given in case of exceeding the standards or fixingindicators on the upper bound.

As a result, a set of 9 to 12 points is considered the norm, the doctor diagnoses that the baby feels good and nothing threatens his he alth. As a rule, doctors do not focus on each of these points, since they are not always easy to understand the first time. It is not at all necessary to know what contractions look like on CTG. According to the results of the study, the doctor can state this fact without a visual demonstration of this phenomenon on the tape.

If a pregnant woman is given 6-8 points, then most likely the baby has signs of developing hypoxia. In the case of training contractions, when the birth is not yet near, the woman may be prescribed therapy and recommendations for increasing outdoor walks. To monitor the he alth of the baby and cases of recurrence of training fights, a repeated CTG is prescribed after a few days. The most unfavorable result is less than 5 points. If such a diagnosis is made at a time when the onset of labor is still far away, or at the first or second stage of labor, a caesarean section may be recommended.

PSP and FIGO

It is important to understand that the essence of the study is not only to find out if CTG shows contractions, but also to establish the pathology or signs of its development in the fetus in time. There are two more criteria for assessing how the baby feels inside the womb:

• PSP - an indicator of the condition of the fetus. The norm is considered to be less than 1, which indicates the well-being and he alth of the child. If the numbers are from 1, 1 to 2, thenfor the doctor, this is a signal that changes are beginning to occur in the baby's body that can be influenced. You can eliminate them with quite affordable drugs, vitamins. It is worth alerting if the indicators are from 2, 1 to 3, which indicates that the child is experiencing severe discomfort. Perhaps the matter is in the entanglement of the umbilical cord, the presence of intrauterine infection. An unqualified reason for hospitalization when PSP is more than 3, an emergency caesarean is indicated.
• The FIGO scoring method is more common in Europe and much less common in Russia. Despite this, his results are more understandable. For those who want to know how to determine contractions and not only by CTG, there are three criteria for the condition of the fetus: normal, doubtful, pathology.

How safe is CTG?

Doctors assure that this research method is absolutely safe for both mother and fetus. However, some try to get information in advance about what it is and how contractions look on CTG. The photo usually does not provide as much information as the reviews of experienced mothers. First of all, you should listen to your feelings, changes in the behavior of the baby. Most pregnant women do not attach importance to the fact that at times the uterus begins to harden and at the same time grabs the lower back. These are practice fights. Cardiotocography allows you to record not only the contraction, but also how the child feels at this time. This is the most important indicator that describes the importance and feasibility of CTG. In this case, the body experiences less stress than with conventional ultrasound.

KTG onover 40 weeks

Women who overstay their pregnancy visit the cardiotocography room more often than others. This is a mandatory procedure for monitoring the he alth of the baby and the ability to determine the onset of labor. An experienced doctor knows what contractions look like on CTG before childbirth and can respond in a timely manner by referring the woman in labor to the maternity hospital or, if she is already under supervision, to the prenatal ward.

Conducting a study at this time allows you to plan the tactics of delivery. In particular, the issue of the need for additional stimulation is being addressed.