A CTG (cardiotocography) is a method of monitoring the fetal heart rate and uterine contractions during pregnancy and birth.

1. Purpose of the CTG: The main purpose of a CTG is to record the fetal heart rate and correlate it with the mother’s uterine contractions. This helps to monitor the fetus’ reaction to the contractions and possible signs of stress or lack of oxygen.
2. Recording the heart rate: The CTG records the fetal heart rate in beats per minute (bpm). A normal fetal heart rate is typically between 110 and 160 bpm. Deviations from this standard may indicate problems.
3. Recording the contractions: The CTG also records the mother’s uterine contractions. This helps to monitor the timing and duration of labor.
4. Interpretation of CTG: The interpretation of CTG is very dependent on the experience of the examiner. Even very experienced doctors can interpret the same CTG very differently.

There are two main types of CTGs: analog CTGs and digital CTGs. Here are the differences between the two:

Analog CTG (paper CTG):

1. Recording on paper: Analog CTG records the fetal heart rate and uterine contractions on a paper strip. This strip shows the information in real time, and doctors and obstetricians can visually monitor the heart rate and contractions.
2. Limited data analysis: With analog CTGs, data analysis is limited. Doctors can recognize patterns such as accelerated or slowed heart rate, increased contractions or absence of heart rate changes, but interpretation depends a lot on experience.
3. Archiving and storage: Analog CTG tapes can be stored in the patient file or as historical records, but are less compatible with digital archiving systems.

Digital CTG:

1. Electronic recording: Digital CTG uses electronic sensors to record the fetal heart rate and uterine contractions. The data is recorded in a digital format and displayed on a monitor.
2. Advanced data analysis: Digital CTGs offer advanced data analysis functions. The software can recognize patterns, trigger alarms and continuously monitor the heart rate. This can help to detect anomalies more quickly and accurately.
3. Improved long-term monitoring: Digital CTGs enable continuous long-term monitoring and a comparison with previous examinations.

In our specialist practice for prenatal medicine, we set the highest standards of fetal monitoring! We use our experience in Doppler sonography and the very best CTG equipment with STV (Short Time Variations) analysis and software, known as Oxford CTGs.

The Oxford CTG is also known as the Dawes-Redman analysis. She has CTG software that should provide more objective data to prevent prenatal misinterpretation of CTGs. The development period was over 35 years at Oxford University. The method is based on the technology with the world’s largest CTGS database and its outcomes. A so-called 100K algorithm contains over 100,000 CTG recordings and their outcomes. We regularly put this worldwide objective computer analysis filtered through our years of clinical experience into practice.
High-risk pregnancies such as those with growth restriction or pre-eclampsia benefit most from this.

Each Oxford CTG is classified as inconspicuous after meeting all the criteria. The following Dawes and Redman analysis criteria apply to all fetuses:

• Short-term variation ≥= 3 ms
• Heart rate between 110-160 HFR, with slightly higher or lower rates acceptable after 30 min if all other parameters are within normal range
• and other criteria…

The short-term variation (STV) is the most significant and important parameter in the Oxford CTG. The mini-changes that cannot be identified by the human eye are analyzed. The oscillation is determined over a very short period of time (up to 10 heartbeats). The short-term variations provide information about the blood flow to the fetal brain and thus about the child’s well-being. This value is so reliable that it has been classified as the most important parameter for fatal monitoring in high-risk cases.

A Cochrane Review has already shown a significant reduction in perinatal mortality rates when using a digital Oxford CTG compared to traditional CTG interpretation (Grivell et al., 2015). At the same time, no increased caesarean section rate was recorded thanks to the Oxford CTG.

By using the latest technology, we can provide much better support for our youngest patients and reassure their parents.

Your expert in prenatal diagnostics and high-risk pregnancy in Hamburg