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Concept
Cardiotocography
Summary
Cardiotocography (CTG) is a technique used to monitor the fetal heartbeat and uterine contractions during pregnancy and labour. The machine used to perform the monitoring is called a cardiotocograph.
Fetal heart sounds were described as early as 350 years ago and approximately 200 years ago mechanical stethoscopes, such as the Pinard horn, were introduced in clinical practice.
Modern-day CTG was developed and introduced in the 1950s and early 1960s by Edward Hon, Roberto Caldeyro-Barcia and Konrad Hammacher. The first commercial fetal monitor (Hewlett-Packard 8020A) was released in 1968.
CTG monitoring is widely used to assess fetal well-being by identifying babies at risk of hypoxia (lack of oxygen). CTG is mainly used during labour. A review found that in the antenatal period (before labour), there is no evidence to suggest that monitoring women with high-risk pregnancies benefits the mother or baby, although research around this is old and should be interpreted with caution. Up-to-date research is needed to provide more information surrounding this practice.
A study found that CTG monitoring didn't significantly improve or worsen the outcome, in terms of preventable child death, post birth mortality, of pregnancy for high risk mothers. But the evidence examined in the study is quite old and there have been significant changes in medical care since then.
External cardiotocography can be used for continuous or intermittent monitoring. The fetal heart rate and the activity of the uterine muscle are detected by two transducers placed on the mother's abdomen, with one above the fetal heart to monitor heart rate, and the other at the fundus of the uterus to measure frequency of contractions. Doppler ultrasound provides the information, which is recorded on a paper strip known as a cardiotocograph (CTG). External tocometry is useful for showing the beginning and end of contractions as well as their frequency, but not the strength of the contractions.
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Ontological neighbourhood
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Pregnancy
Pregnancy is the time during which one or more offspring develops (gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but can also occur through assisted reproductive technology procedures. A pregnancy may end in a live birth, a miscarriage, an induced abortion, or a stillbirth. Childbirth typically occurs around 40 weeks from the start of the last menstrual period (LMP), a span known as the gestational age.
Amniotic sac
The amniotic sac, also called the bag of waters or the membranes, is the sac in which the embryo and later fetus develops in amniotes. It is a thin but tough transparent pair of membranes that hold a developing embryo (and later fetus) until shortly before birth. The inner of these membranes, the amnion, encloses the amniotic cavity, containing the amniotic fluid and the embryo. The outer membrane, the chorion, contains the amnion and is part of the placenta.
Doppler fetal monitor
A Doppler fetal monitor is a hand-held ultrasound transducer used to detect the fetal heartbeat for prenatal care. It uses the Doppler effect to provide an audible simulation of the heart beat. Some models also display the heart rate in beats per minute (BPM). Use of this monitor is sometimes known as Doppler auscultation. The Doppler fetal monitor is commonly referred to simply as a Doppler or fetal Doppler. It may be classified as a form of Doppler ultrasonography (although usually not technically -graphy but rather sound-generating).