Sometimes the maternal artery movement is double counted so MHR x 2 is displayed. The FHR displayed will then actually be the maternal heart rate, MHR. The ultrasound may then pick up the maternal pulse from the aorta, iliac or uterine artery. It was later suspected that in both cases the trace was showing double maternal rate and was falsely reassuring.Įxplanation: The fetus can move out of the ultrasound field or in extreme cases the fetal heart can stop beating. In the other the baby required extensive resuscitation. The maternal pulse had been noted earlier at around 80 bpm. CTG users should be aware of the limitations and artefacts that can occur, which have important implications for interpretation.īelow are two examples of situations that have occurred in UK hospitals.Įxample 1: In two recently reported incidents the CTG trace showed the FHR was around 160 bpm. The problem is that adverse incident reports often state that the fetal heart rate was in the normal range and staff only suspect a FHR abnormality after the event. These guidelines also recommend that the maternal pulse is palpated if a FHR abnormality is detected, in order to differentiate the two heart rates (sections 1.6.13 observations during first stage of labour and 1.7.6 second stage). It then uses these features to define ‘Normal’, ‘Suspicious’ and ‘Pathological’ FHR traces. It also gives values for ‘Reassuring’, ‘Non-reassuring’ and ‘Abnormal’. The NICE clinical guideline 55 ‘Intrapartum care’ (chapter 1.12.2 Interpretation of FHR traces/cardiotocographs) classifies four FHR trace features: ‘Baseline’, ‘Variability’, ‘Decelerations’ and ‘Accelerations’. ProblemĪdverse outcomes are still being reported in the presence of CTG traces that appear normal.įor example, the display of double maternal heart rate (MHR x 2) can be falsely reassuring.Ĭardiotocographs assist in the management of labour, but should not be relied upon in isolation to monitor the condition of the fetus. During labour, they give an indication of how the fetal heart rate (FHR) is responding to the stress caused by maternal contractions. Other chronic conditions: People with hyperthyroidism, diabetes, asthma and other chronic medical problems.This replaces SN 2002(23) issued August 2002.Ĭardiotocographs (CTGs) monitor the fetal heart rate with an ultrasound transducer and maternal contractions with a toco (strain gauge) transducer.
Sleep apnea: Studies s demonstrate a strong link between obstructive sleep apnea and atrial fibrillationĭrinking alcohol: Heavy alcohol consumption is associated with a higher risk of atrial fibrillationįamily history: Having a family history of atrial fibrillation increases your risk. Atrial fibrillation is the most common complication after heart surgery. Underlying heart disease: including valve disease, acute coronary syndrome, cardiomyopathies, and history of heart attack. High blood pressure: Uncontrolled and longstanding high blood pressure can increase your risk for atrial fibrillation
The condition in young adults is rare, but it can and does happen. Regular monitoring of atrial fibrillation is beneficial particularly if some of the following risk factors apply to you:Īdvanced age: The number of adults developing atrial fibrillation increases significantly with older age.
Cardiograph bpm normal how to#
How to recognize if you are at risk of atrial fibrillationĪtrial fibrillation may present at any age and without noticeable symptoms.
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