International expert consensus statement on physiological interpretation of cardiotocograph (CTG): First revision (2024)

The first international consensus guideline on physiological interpretation of cardiotocograph (CTG) produced by 44 CTG experts from 14 countries was published in 2018. This guideline ensured a paradigm shift from classifying CTG by arbitrarily grouping certain features of the fetal heart rate into...

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Bibliographic Details
Published in:	European journal of obstetrics & gynecology and reproductive biology Vol. 302; pp. 346 - 355
Main Authors:	Chandraharan, Edwin, Pereira, Susana, Ghi, Tullio, Gracia Perez-Bonfils, Anna, Fieni, Stefania, Jia, Yan-Ju, Griffiths, Katherine, Sukumaran, Suganya, Ingram, Caron, Reeves, Katharine, Bolten, Mareike, Loser, Katrine, Carreras, Elena, Suy, Anna, Garcia-Ruiz, Itziar, Galli, Letizia, Zaima, Ahmed
Format:	Journal Article
Language:	English
Published:	Ireland Elsevier B.V 01-11-2024
Subjects:	Cardiotocograph (CTG) Cardiotocography Chorioamnionitis Consensus Female Fetal heart rate cycling Fetal Hypoxia - diagnosis Fetal Hypoxia - physiopathology Heart Rate, Fetal - physiology How is THIS Fetus? Humans Pregnancy Relative utero-placental insufficiency of labour (RUP-L) Suggestive of Fetal Inflammation (SOFI) ZigZag Pattern How is THIS Fetus? ZigZag Pattern Chorioamnionitis Cardiotocograph (CTG) Fetal heart rate cycling Relative utero-placental insufficiency of labour (RUP-L) Suggestive of Fetal Inflammation (SOFI)
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Summary:	The first international consensus guideline on physiological interpretation of cardiotocograph (CTG) produced by 44 CTG experts from 14 countries was published in 2018. This guideline ensured a paradigm shift from classifying CTG by arbitrarily grouping certain features of the fetal heart rate into different “categories”, and then, randomly combining them to arrive at an overall classification of CTG traces into “Normal, Suspicious and Pathological” (or Category I, II and III) to a classification which is based on the understanding of fetal pathophysiology. The guideline recommended the recognition of different types of fetal hypoxia, and the determination of features of fetal compensatory responses as well as decompensation to ongoing hypoxic stress on the CTG trace. Since its first publication in 2018, there have been several scientific publications relating physiological interpretation of CTG, especially relating to features indicative of autonomic instability due to hypoxic stress (i.e., the ZigZag pattern), and of fetal inflammation. Moreover, emerging evidence has suggested improvement in maternal and perinatal outcomes in maternity units which had implemented physiological interpretation of CTG. Therefore, the guideline on Physiological Interpretation of CTG has been revised to incorporate new scientific evidence, and the interpretation table has been expanded to include features of chorioamnionitis and relative utero-placental insufficiency of labour (RUPI-L).
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Instructional Material/Guideline-3 content type line 23
ISSN:	0301-2115 1872-7654 1872-7654
DOI:	10.1016/j.ejogrb.2024.09.034