Physiological Interpretation of CTG From Knowledge to Practice: Volume 2: Recognising Non-Hypoxic insults Paperback – May 15, 2022

Cardiotocograph (CTG Trace) was introduced as a test aimed to detect fetal hypoxic stress. However, the larger, and more diverse, and often misunderstood mechanisms of peripartum fetal injury operate through systemic maternal and fetal inflammatory responses, fetal hypovolemia secondary a loss of fetal blood volume, as well as thermal, traumatic, and metabolic insults to the developing fetal brain. These “Non-Hypoxic” pathways seldom manifest through the occurrence of repetitive, “ugly” decelerations on the fetal heart rate tracing. This book is aimed at practising midwives, obstetricians, student midwives and residents/trainees who have embraced a physiological approach to fetal heart rate interpretation during labour, and wish to further their knowledge on the recognition of “Non-Hypoxic” causes of fetal compromise. The chapters are designed to help translate the knowledge of Physiological Interpretation of CTG into clinical practice to ensure excellent maternal and fetal outcomes. FHR features suggestive of chorioamnionitis, chronic fetal anaemia and acidosis, fetal arrhythmias, intrauterine fetal stroke, and intrauterine convulsions as well as expected FHR changes in operative vaginal births are illustrated with case examples. The effects of meconium staining of amniotic fluid and features of neuroinflammation such as the “ZigZag” and “Poole Shark Teeth” patterns are discussed, The CTG exercises with answers are designed to ensure readers’ active participation and to promote a greater understanding of Physiological Interpretation of CTGs.The KATKITs ( Knowledge Acquisition & Transfer of Knowledge through Innovative Team Training) are designed to help readers to implement the principles of physiological interpretation of CTG into their daily clinical practice. “Risk Management and Medico-legal Pitfalls” highlights the common errors whilst interpreting CTG traces in the presence of “Non-Hypoxic” causes of fetal compromise which may lead to poor perinatal outcomes and resultant litigation. Read more