KTG examination (cardiotocography), i.e. monitoring of the fetal heart function with simultaneous recording of uterine contractions, is one of the basic tests in modern obstetrics. They are performed at the end of pregnancy and labor in order to know the condition of the baby and to be able to react as soon as possible in the event of a threat.

KTGi.e.cardiotocographyconsists of two elements: tokography, i.e. recording of uterine contractions, and cardiography, i.e. recording of the fetal heart rate . Why and when is CTG done? For a child, squeezing through the tight birth canal is not a pleasant trip, but a very exhausting effort. During this tiring journey, the baby is exposed to certain dangers, which can be recognized by observing the frequency of his heartbeat. For example, a too low frequency may indicate hypoxia, while an accelerated heartbeat may be a signal that an intrauterine infection has occurred.

KTG in two ways

KTG examination can be performed in two ways - through external or internal monitoring.

  • External monitoring- it is used most often, it is a non-invasive examination, it does not involve any pain or risk. A pregnant (or giving birth) woman is lying down, two belts with two sensors are put on her belly. One is an ultrasound transducer that records the fetal heartbeat, and the other is a meter that measures the strength and duration of uterine contractions. Both sensors are connected to a monitor that displays or prints the measurement values. Basic CTG examination should last 30 minutes, or it may be extended to 60 minutes.
  • Internal monitoring- is used when the doctor needs a more precise measurement, e.g. when he suspects that the fetus is at risk. An electrode for assessing the baby's heartbeats is placed on the baby's head by inserting it through the cervix. The examination is therefore only possible when the membranes are ruptured and the cervix is ​​at least 1-2 cm dilated. The strength of uterine contractions can be measured by a sensor on the abdomen (as in external monitoring) or by a catheter inserted into the uterus. Because the sensor introduces itself inside the body (and so is itinvasive test), there is a slight risk of infection. Placing the electrode on the head can also be painful for the baby. For these reasons, this type of monitoring is used very rarely, only in justified cases.

Note:While the record of the good condition of the child is almost always reliable, the reading showing abnormal condition is sometimes false. This may be due to a malfunctioning device or interference caused by changes in the severity and frequency of contractions. It often happens that the examined woman temporarily takes a position in which her main vein or umbilical cord is compressed - after changing the position of the body, the CTG result immediately improves.

Worth knowing

Oxytocin Test

Sometimes CTG testing is done with the administration of pregnant oxytocin, which causes the uterus to contract. In this way, the efficiency of the placenta is checked during uterine contractions. The doctor may order this test if the woman had complications in a previous pregnancy or the current pregnancy is a high-risk pregnancy.

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Permanent monitoring

In some hospitals, fetal monitoring is performed throughout the entire birth process. Unfortunately, what is beneficial for the child can be a great inconvenience for the mother in labor, because usually during the CTG she is not able to freely change position, move, etc. Therefore, if a woman wants to give birth actively, she should inform the doctor about it and - if the delivery is correct - ask it to be disconnected from time to time from the CTG apparatus. The World He alth Organization (WHO) recommends that continuous monitoring be performed only in carefully selected cases (associated with a high probability of perinatal mortality) and in induced (induced) births.

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Pregnant examinations