In plain words
Cardiotocography, often shortened to CTG, is a monitor that records the baby's heart rate and the mother's contractions at the same time. Two belts go around the belly, one for the heart rate and one for the uterus. The result is a printed or on-screen trace. Clinicians read the trace to see how the baby handles contractions and whether the heart rate rises and falls in expected ways. A CTG can be used during labor. It is also used in late pregnancy to check on a baby when there are concerns. A normal trace reflects the moment it was recorded. Reading a trace takes training, and two people may read the same strip differently.
The deeper version
Cardiotocography records fetal heart rate by Doppler ultrasound and uterine activity by external tocodynamometry or an intrauterine pressure catheter. Interpretation considers baseline rate, variability, accelerations, decelerations, and the contraction pattern, using standardized terminology from NICE and ACOG. Routine use in low-risk labor has not been shown to improve perinatal outcomes, and it is associated with more operative delivery, which is the main controversy (Alfirevic and colleagues, Cochrane, 2017). In antepartum testing, a reactive trace or biophysical profile reflects the fetus at the time of testing and does not predict later events. Interpretive variation is substantial, and training and standard terms reduce it.
Where it comes up
- Baby moving less: what to doPregnancy: Your Body
- Itching that won't stop: cholestasisPregnancy: Your Body
- Signs labor is startingGetting Ready for Birth
- The stages of labor, plainlyBirth and the First Days
- Induction: why, how, and what to askGetting Ready for Birth
What mothers here say about cardiotocography
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Sources
- Alfirevic Z and colleagues — Continuous cardiotocography as a form of electronic fetal monitoring for fetal assessment during labour. Cochrane Database of Systematic Reviews, 2017
- American College of Obstetricians and Gynecologists — Practice Bulletin No. 145: Antepartum Fetal Surveillance, 2014