Maternal and fetal indications for CTG (Che) by Mark Miller https://padlet.com/mark_miller3/v843xw09m159 Chelmsford en-us 2016-08-24 12:32:51 UTC 2018-05-14 08:23:32 UTC hello@padlet.com Group 1  https://padlet.com/mark_miller3/v843xw09m159/wish/125880107 Maternal Indications for CTG: 

VBAC - Continuous monitoring recommended (at the onset of regular uterine contractions) to assess for signs of uterine scar rupture.

Antepartum haemorrhage - CTG commenced to asses condition of the fetus and aid decision on mode and timing of delivery. 


]]> 2016-09-22 22:02:01 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/125880107 Group 1: 1402297 https://padlet.com/mark_miller3/v843xw09m159/wish/126174325 Induction Of Labour:
> Ensure drugs given are working effectively 
> Monitor uterine contractions 
> Keep an eye out for fetal distress 

Epidural: 
> Continuous Monitoring of the neonate 
> ensure no fetal distress 
> Monitor uterine contractions and fetal movement
> Monitor Fetal heart Rate 

]]> 2016-09-24 17:20:11 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126174325 Group 1  https://padlet.com/mark_miller3/v843xw09m159/wish/126195474
  • suspected chorioamnionitis or sepsis, or a temperature of 38°C or above
  • severe hypertension (160/110 mmHg or above)
  • oxytocin use
  • the presence of significant meconium 
  • fresh vaginal bleeding that develops in labour
    • (NICE Guidelines)
    ]]>     2016-09-25 07:45:37 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126195474     Group 1 1503346 https://padlet.com/mark_miller3/v843xw09m159/wish/126195526
  • suspected chorioamnionitis or sepsis, or a temperature of 38°C or above
  • severe hypertension (160/110 mmHg or above) 
  • oxytocin use
  • the presence of significant meconium 
  • fresh vaginal bleeding that develops in labour.

    • ]]>     2016-09-25 07:47:49 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126195526     -Epidural for pain relief https://padlet.com/mark_miller3/v843xw09m159/wish/126221600 -Infection or query infection
    -Multiple pregnancy
    -Over 24 hours since rupture or membranes ]]>     2016-09-25 16:52:44 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126221600     Group 4 https://padlet.com/mark_miller3/v843xw09m159/wish/126228806 Unforseen Indications for CTG:

    Fresh vaginal bleeding during labour.
    Augmentation of labour using oxytocin.
    Maternal pyrexia >38C therefore suspected chorioamnionitis or sepsis
    Severe hypertension >160/110mm Hg.
    Any 2 or more of :
    -confirmed delay in first or second stage.
    -non significant meconium
    -prolonged period since ROM (24 hours or more)
    -moderate hypertension 150/100 to 159/109 mm Hg.


    ]]>     2016-09-25 18:46:56 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126228806     Grp 4 https://padlet.com/mark_miller3/v843xw09m159/wish/126303476 NICE Guidelines (2014):
    If any one of the following risk factors is present or arises during labour:
    * prolonged period since rupture of membranes (24 hours or more)
    * moderate hypertension (150/100 to 159/109 mmHg)
    * confirmed delay in the first or second stage of labour
    * the presence of non-significant meconium.

    Do not regard amniotomy alone for suspected delay in the established first stage of labour as an indication to start continuous cardiotocography.

    NICE (2015) Fetal Monitoring During Labour. nice.org.uk [online] Available At: http://pathways.nice.org.uk/pathways/intrapartum-care/fetal-monitoring-during-labour#content=view-node%3Anodes-indications-for-continuous-cardiotocography-and-telemetry.



    ]]>     2016-09-26 09:42:22 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126303476     Any indication of diminished movement - reported by mum, due to position of placenta, e.g placenta previa, also placenta at front of uterus. CTG to record fetal movements and HR. https://padlet.com/mark_miller3/v843xw09m159/wish/126368198 Small for dates babies.
    Low levels of amniotic fluid noted in scan.
    Indications of pre-eclampsia.
    Any sever pain/ illness in mother - e/g influenza (swine flu) or another illness, gall stones/ kidney stones.]]>     2016-09-26 13:49:37 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126368198     1506040 https://padlet.com/mark_miller3/v843xw09m159/wish/126403404 -Fresh vaginal bleeding that has began in labour
    -Oxytocin use (NICE 2014)

    ]]>     2016-09-26 15:10:46 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126403404     Group 1 continued.... https://padlet.com/mark_miller3/v843xw09m159/wish/126464814
    NICE recommends continous intrapartum CTG monitoring for maternal pyrexia >38C

    NICE also recommends continous CTG for at least 30mins during establishment of PCEA  and after administration of each bolus of 10mls or more. 



    ]]>     2016-09-26 17:52:15 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126464814     Group 2                 1502826 https://padlet.com/mark_miller3/v843xw09m159/wish/126670704 Indications from fetus:
    IUGR.
    Prematurity.
    Bradycardia.
    Tachycardia.
    Decelerations.
    Reduced/ no movements.
    Baby who has experienced ECV.

    ]]>     2016-09-27 14:14:32 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126670704     Group 1.Maternal : APH to assess condition of fetus. Fetal: Reduced fetal movements to assess fetus on Dawes Redman. Conraindications: There should always be a reason for doing the CTG for example for fetal well being https://padlet.com/mark_miller3/v843xw09m159/wish/126704432 2016-09-27 15:23:31 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126704432 https://padlet.com/mark_miller3/v843xw09m159/wish/126757078 Decelerations heard during intermittent auscultation for an otherwise low risk labour.
    Known fetal abnormality.
    Prior to and post prostin/propess.]]>     2016-09-27 17:32:17 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126757078     Group 2 CTG https://padlet.com/mark_miller3/v843xw09m159/wish/126786642 If the woman reports reduced or absent fetal movements.
    Before and after an external cephalic version for breech.
    CTG is recommended twice weekly for gestations >42 weeks and induction of labour has been declined.

    If any of these risk factors are present or arise during labour:
    oxytocin use,
    presence of significant meconium,
    suspected chorioamnionitis or sepsis,
    temperature ≥ 38°C,
    severe hypertension 160/110 mmHg or above,
    fresh intrapartum vaginal bleeding.

    ]]>     2016-09-27 18:49:22 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126786642     1519420 (Grp2) https://padlet.com/mark_miller3/v843xw09m159/wish/126814121 fetal ctg : tachycardia, bradycardia, decelerations,  low variability : all signs of fetal distress
    fetal assessment may be needed for women with: previous stillbirth, neonatal death, diabetes, hypertension. women can also develop reduced fetal movement, interuterine growth restriction, hypertension during pregnancy which also may require fetal monitoring.
    (fetal monitoring in practice, Gibb & Arulkumaran, 2008.


    ]]>     2016-09-27 20:39:26 UTC https://padlet.com/mark_miller3/v843xw09m159/wish/126814121