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NST or CTG

By AdminPosted On 05-Oct-2016

1. Early deceleration is NST


a) Associated with unengaged head

b) Associated usually with brain hypoxia

c) Decrease in the fetal beat that peaks after uterine contraction

d) Indication of c-section.

e) Results from increased vagal tone secondary to head compression.

Correct Answer: e) Results from increased vagal tone secondary to head compression. Early decelerations are caused by compression of the fetal head, and late decelerations are caused by fetal hypoxia that is secondary to placental insufficiency. The nadir of the early deceleration occurs with the peak of a contraction. Early decelerations are caused by vagal discharge produced when the head is compressed by uterine contractions.


2. Variable Decelerations


Cardiotocograph shows type 1 variable decelerations. What is the cause of this feature?


a) Fetal head compression

b) Fetal hypoxia

c) Fetal movements

d) Placental insufficiency

e) Umbilical cord compression


Correct Answer: e) Umbilical cord compression. Variable decelerations are due to umbilical cord compression. Early decelerations are caused by compression of the fetal head, and late decelerations are caused by fetal hypoxia that is secondary to placental insufficiency. Fetal movements are related to accelerations.


3. Cardiotocography (CTG)


Cardiotocography (CTG) is the most commonly used test for antepartum and intrapartum foetal surveillance. Negative predictive value of Normal CTG (% of fetuses with a normal CTG that will be born non-hypoxic) is


a) 50%-60%

b) 60%-70%

c) 70%-80%

d) 80%-90%

e) >90%


Correct Answer: e) >90%. CTG has very High negative predictive value. >98% of fetuses with a normal CTG will be OK. It has Poor positive predictive value. Therefore the CTG should always be interpreted in its clinical context and backed by fetal blood sampling


4. CTG


Positive predictive value of pathological CTG (% of fetuses with a abnormal CTG that will be born hypoxic)


a) b) 40%-50%

c) 50%-60%

d) 60%-70%

e) >70%


Correct Answer: b) 40%-50%. Even" a" would also go as correct answer, as some studies found

5. Classify this CTG as


Image title



a) NormNST in Mumbaial

b) Suspicious

c) Pathological

And state number of 1) Reassuring, 2) Nonreassuring or 3) Abnormal patterns.


Correct Answer: Variable deceleration. Fetal heart rate is 130 to 140 beats per minute, and beat-to-beat variability is preserved. It is moderate variable deceleration as the duration is between 30 and 60 seconds. Variable decelerations are generally associated with a favorable outcome. This trace has only one non-reassuring feature, so it is suspicious trace.


6. NST


Image title



CTG oNon Stress Testutput for a woman not in labour. What does this CTG read?




Correct Answer: Normal trace is defied as an FHR trace in which all four features are classified as reassuring. Reassuring FHR is when: Baseline: 110–160; Variability: ≥ 5; Deccelerations: None and Accelerations: Present. SO THIS TRACE IS NORMAL AS IT HAS ALL 4 COMPONENTS OF REASSURING.


7. What is abnormal in these CTG?


Image title


NST by Dr. Niraj Mahajana) Variable deceleration

b) Late deceleration

c) Sinusoidal pattern

d) Saltatory pattern

e) Reduced variability


Correct Answer: d) Saltatory pattern. It consists of FHR fluctuations >25 bpm occurring either 3 to 6, or >6 times per minute. It is usually caused by acute hypoxia or mechanical compression of the umbilical cord. This pattern is most often seen during the second stage of labor. The presence of a saltatory pattern, especially when paired with decelerations, should warn the physician to look for and try to correct possible causes of acute hypoxia and to be alert for signs that the hypoxia is progressing to acidosis. Although it is a nonreassuring pattern, the saltatory pattern is usually not an indication for immediate delivery.


8. What does this CTG read? Two abnormal findings


Correct Answer: Cardiotocographic shows repetitive late decelerations and decreased variability. THIS CTG HAS TWO ABNORMAL FEATURES SO THIS TRACE IS PATHOLOGICAL.

Pathological trace is defined as An FHR trace with two or more features classified as non-reassuring or one or

more classified as abnormal.

Non- reassuring: Baseline: 100–109; 161–180. Variability: Abnormal : Baseline: 180; Sinusoidal pattern ≥10minutes. Variability:


9. Read this CTG


Correct Answer: Trace has 2 abnormal findings i.e. Sinusoidal pattern and Variability:

A sinusoidal fetal FHR pattern is defined as a pattern of fixed, uniform fluxuations of the FHR that creates a pattern resembling successive geometric sine waves. It frequently is described as undulating and smooth and is characterized by the absence of variability.


True" sinusoidal FHR patterns are associated with the following fetal conditions that result in either severe fetal anemia or severe/prolonged fetal hypoxia with acidosis.


10. What does following CTG read?


a) Normal trace - All four features classified as reassuring are present.


b) Suspicious - One feature classified as non-reassuring and the remaining features classified as reassuring


c) Pathological trace - Two or more features classified as non-reassuring or one or more classified as abnormal.


Correct Answer: c) Pathological. Two Non-reassuring pattern of No acceleration with poor beat-to-beat variability (2-4) and one abnormal pattern of late decelerations.




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MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.

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