What is a Cardiotocography (CTG)?

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From the Guidelines

A CTG, or cardiotocography, is a primary method for fetal surveillance in high-risk pregnancies, used to monitor fetal heart rate and uterine contractions simultaneously. This is based on the most recent evidence from the American Journal of Obstetrics and Gynecology, which states that CTG is currently accepted as the primary method for fetal surveillance in high-risk pregnancies in the United States 1.

Key Points About CTG

  • CTG is a non-invasive monitoring technique that provides healthcare providers with important information about fetal well-being and how the baby is responding to labor.
  • The test involves placing two sensors on the mother's abdomen - one to detect the baby's heartbeat and another to measure contractions.
  • CTG monitoring can be performed as a short-term assessment during prenatal visits or as continuous monitoring during labor.
  • Healthcare providers interpret the CTG patterns to identify potential signs of fetal distress, such as abnormal heart rate patterns or concerning responses to contractions.
  • According to the study published in 2020, a normal CTG in pregnancies with fetal growth restriction (FGR) is more likely to be associated with a normal perinatal outcome 1.
  • The presence of spontaneous repetitive late decelerations on CTG is accepted as an indication for delivery in viable pregnancies with FGR, irrespective of Doppler findings 1.

From the Research

Definition of CTG

  • Cardiotocography (CTG) is a continuous recording of the fetal heart rate obtained via an ultrasound transducer placed on the mother's abdomen 2.
  • CTG is widely used in pregnancy as a method of assessing fetal well-being, predominantly in pregnancies with increased risk of complications 2.

Purpose of CTG

  • The purpose of CTG is to assess the effectiveness of antenatal CTG in improving outcomes for mothers and babies during and after pregnancy 2.
  • CTG is used to monitor fetal heart rate and detect any potential issues or complications during pregnancy 3, 4, 5, 6.

Types of CTG

  • There are two types of CTG: traditional and computerized 2.
  • Computerized CTG has been shown to be more effective in reducing perinatal mortality compared to traditional CTG 2.

Uses of CTG

  • CTG is used in high-risk pregnancies, such as those with diabetes, to monitor fetal well-being and detect any potential issues 6.
  • CTG is also used in conjunction with other tests, such as the biophysical profile, to assess fetal well-being 3, 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Antenatal cardiotocography for fetal assessment.

The Cochrane database of systematic reviews, 2015

Research

Computerized fetal heart rate analysis, Doppler ultrasound and biophysical profile score in the prediction of acid-base status of growth-restricted fetuses.

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2007

Research

The fetal biophysical profile and its predictive value.

Obstetrics and gynecology, 1983

Research

Cardiotocography and diabetic pregnancy.

JPMA. The Journal of the Pakistan Medical Association, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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