Cardiotocography Course

Lesson 1 • Fetal Cardiovascular Physiology

Examines fetal cardiac output, autonomic control, and chemoreceptor function. Provides the physiological framework for understanding FHR pattern origins.

Lesson 2 • History and Development of CTG

Traces the evolution of electronic fetal monitoring from auscultation to modern CTG. Contextualises current practice within evidence-based development.

Lesson 3 • Uterine Activity and Contractions

Defines normal and abnormal uterine contraction patterns and their haemodynamic impact on the fetus. Links contraction assessment to CTG interpretation.

Lesson 1 • External Monitoring Transducers

Describes Doppler ultrasound and tocodynamometry transducers, their placement, and limitations. Establishes correct technique for non-invasive monitoring setup.

Lesson 2 • Internal Monitoring Devices

Covers fetal scalp electrode and intrauterine pressure catheter use, indications, and contraindications. Provides criteria for selecting internal over external monitoring.

Lesson 3 • Signal Quality and Artifact Recognition

Identifies sources of signal loss, artifact, and maternal heart rate recording. Teaches systematic quality checks before interpretation begins.

Lesson 1 • Accelerations: Types and Significance

Defines reactive and non-reactive patterns, acceleration criteria by gestational age, and their reassuring value. Connects acceleration presence to fetal wellbeing.

Lesson 2 • Baseline Fetal Heart Rate

Defines normal baseline range, tachycardia, and bradycardia with their clinical significance. Teaches accurate baseline determination excluding accelerations and decelerations.

Lesson 3 • Deceleration Morphology and Timing

Analyses early, late, variable, and prolonged decelerations by onset, nadir, and recovery timing. Distinguishes benign from pathological deceleration patterns.

Lesson 4 • Baseline Variability Assessment

Covers amplitude and frequency of short-term variability, classification bands, and physiological determinants. Links variability to fetal neurological integrity.

Lesson 1 • Gestational Age Considerations

Adjusts classification criteria for preterm fetuses where normal ranges differ from term. Prevents misclassification of developmentally normal preterm patterns.

Lesson 2 • Suspicious and Pathological CTG

Distinguishes suspicious from pathological classifications and their escalating clinical urgency. Teaches threshold recognition for immediate intervention triggers.

Lesson 3 • Feature-Based Classification Approach

Introduces the four-feature assessment model assigning each feature a category. Demonstrates how individual feature categories combine into an overall trace classification.

Lesson 1 • Second Stage Labour Monitoring

Addresses physiological FHR changes during pushing and their distinction from pathological patterns. Guides decision-making for operative delivery timing.

Lesson 2 • Clinical Context Integration

Incorporates maternal risk factors, obstetric history, and intrapartum events into CTG interpretation. Demonstrates how context modifies the significance of CTG findings.

Lesson 3 • First Stage Labour Monitoring

Applies CTG interpretation to the latent and active phases with stage-specific normal variation. Identifies early signs of fetal compromise during cervical dilatation.

Lesson 4 • Admission CTG Assessment

Establishes the role of the admission CTG in identifying high-risk fetuses at labour onset. Defines criteria for continuing or discontinuing monitoring based on findings.

Lesson 1 • Fetal Pulse Oximetry

Examines the evidence base, technique, and limitations of intrapartum fetal pulse oximetry. Evaluates its role as a CTG adjunct in clinical practice.

Lesson 2 • Biophysical Profile Scoring

Describes the five-component BPS and its role in antepartum fetal surveillance. Connects BPS findings to CTG interpretation in high-risk pregnancies.

Lesson 3 • Fetal Scalp Blood Sampling

Covers indications, technique, and interpretation of fetal scalp pH and lactate sampling. Positions FBS as a decision-support tool for suspicious or pathological CTG.

Lesson 1 • CTG in Preterm Labour

Addresses monitoring challenges and interpretation differences in preterm labour. Balances intervention risk against fetal compromise detection in early gestation.

Lesson 2 • Reduced Fetal Movement and CTG

Links maternal perception of reduced fetal movement to CTG assessment protocols. Defines the appropriate clinical pathway when movement reduction is reported.

Lesson 3 • CTG in High-Risk Pregnancies

Adapts CTG interpretation for conditions including IUGR, diabetes, hypertension, and post-dates. Identifies condition-specific FHR patterns and monitoring frequency.

Lesson 1 • Neonatal Resuscitation Preparation

Prepares clinicians to anticipate neonatal compromise based on intrapartum CTG findings. Links CTG deterioration patterns to neonatal team activation and preparation.

Lesson 2 • Escalation and Communication Protocols

Defines structured escalation pathways and communication frameworks for CTG concerns. Reduces delay between recognition and appropriate clinical response.

Lesson 3 • Delivery Decision Timing

Establishes criteria and urgency categories for operative delivery based on CTG findings. Aligns delivery timing with fetal compromise severity and clinical context.

Lesson 4 • Conservative Measures for CTG Concerns

Outlines first-line interventions to improve fetal oxygenation before escalating to delivery. Teaches systematic application of conservative measures with reassessment.