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

Autor: Chandraharan E; Global Academy of Medical Education & Training, London, UK. Electronic address: edwin.c@sky.com., Pereira S; Consultant in Maternal-Fetal Medicine & Clinical Director, The Royal London Hospital, Barts Health NHS Trust, London, UK., Ghi T; Department of Medicine and Surgery, University of Parma, Italy., Gracia Perez-Bonfils A; Consultant Obstetrician & Labour Ward Consultant, Germans Trias i Pujol, Barcelona, Spain., Fieni S; Unit of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy., Jia YJ; Department of Obstetrics, Tianjin Central Hospital of Obstetrics and Gynaecology, Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin, China., Griffiths K; Royal College of Midwives, UK. Electronic address: katherine.griffiths6@nhs.net., Sukumaran S; Consultant Obstetrician and Gynaecologist, George Eliot Hospital NHS Trust, UK. Electronic address: suganya.sukumaran@geh.nhs.uk., Ingram C; Barking, Havering and Redbridge University Hospitals NHS Trust, the United Kingdom of Great Britain and Northern Ireland., Reeves K; Formerly, Fetal Surveillance Midwife, Broomfield Hospital, Essex, UK., Bolten M; Consultant Obstetrics, Gynaecology and Fetal Medicine, Labour Ward & Caesarean Section Lead, Queen Elizabeth Hospital Woolwich, Stadium Road, London, SE18 4QH, UK. Electronic address: mareike.bolten@nhs.net., Loser K; Lead Obstetrician at the Hospital of Southern Jutland, Aabenraa, Denmark. Electronic address: katrin.loeser@rsyd.dk., Carreras E; Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron University Hospital, Spain; Universitat de Vic-Universitat Central de Catalunya, Spain., Suy A; Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron University Hospital, Spain., Garcia-Ruiz I; Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron University Hospital, Spain., Galli L; Consultant in Obstetrics, Unit of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy., Zaima A; Obstetrician & Gynaecologist, Kingston Hospital, UK & Member of Advisory Board, UK.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2024 Nov; Vol. 302, pp. 346-355. Date of Electronic Publication: 2024 Oct 02.
DOI: 10.1016/j.ejogrb.2024.09.034
Abstrakt: 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).
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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