Recognition of chronic hypoxia and pre-existing foetal injury on the cardiotocograph (CTG): Urgent need to think beyond the guidelines
Susana Pereiraa,, , Edwin Chandraharanb
a Kingston Hospital NHS Foundation Trust, Galsworthy Road, Kingston upon Thames, Surrey, UK
b St. George's University Hospitals NHS Foundation Trust & St George's University of London, Blackshaw Road, London, UK
Received 14 November 2016, Accepted 11 January 2017

Chronic utero-placental insufficiency may result in progressive hypoxia culminating in fetal decompensation and acidosis and this is termed ‘chronic’ or ‘long-standing’ hypoxia. It is essential to recognise the features of chronic hypoxia on the CTG trace so as to institute timely and appropriate action. The current guidelines may not capture a fetus who starts labour already compromised or limited in its ability to compensate for hypoxic or mechanical stresses during labour. The aim of this short review is to explore the CTG features that allow the clinician to recognise a fetus who may present with an antenatal insult such as chronic hypoxia, anaemia, infection, fetal arrhythmias and preexisting non-hypoxic brain injury.

CTG monitoring, Cardiotocography, Chronic hypoxia, Fetal anaemia, Fetal stroke

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