Wednesday, December 15, 2010

CTG : changing in baseline to bradycardia - what to do?

CTG shown changing in baseline from 140bpm to 110bpm (bradycardia).

What are your actions?

110bpm can be maternal heart rate.
Check maternal pulse.
Check the pulse rate whether it correspond to about 110bpm.
Check whether maternal pulse is correspond to the rhythm of CTG.

Position may be incorrect.
Ensure correct positioning of US to the anterior shoulder of the fetus.

If persistent,
do vaginal examination.
If os fully --> delivery with instrumental delivery
If os still not fully --> EmLSCS

Info during CTG workshop. If there is any mistake, please comment. TQ


~YM~ said...

bagusnya ctg workshop kamu. Workshop saya cuma belajar pasal characteristic of CTG macam dalam protokol.

Tapi adalah kena ikut "step" tertentu, seperti tengok dahulu type of decelerations etc. Topik nie boleh buat satu lecture kalau nak bincang pasal fetal bradycardia je.

Tambahan lagi, kalau brady/ non-reassuring:
1) Assess patient clinically for any cause (anemia, APH, tachypnea, hydration, etc)
2) Check maternal position @ left lateral and abdomen palpation to determine route of delivery, instrumental/EMLSCS (Check strength of contraction, lie of fetus, engagement, etc)
3) Vital sign monitoring - BP, pulse, Temp
4) Check CTG contact
5) VE to exclude cord prolapse and to determine os dilatation, station, position (OA,OP,OT etc) and molding.

Consideration of instrumental delivery and LSCS will depend on the findings, so a proper assessment is needed. Kalau tak, akan dilabel VE student. :P

Sumber: Dari yg dicari sendiri dan juga dari teaching daripada prof zainul. :P

syed muhammad said...

call registrar!

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