Practical Cardiotocography

257 Pages·2005·5.884 MB·English

by  Debdas AK.;

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Disclaimer
Notice
The author has used his best efforts to provide information that
is uptodate and accurate and is generally accepted within medical
standards at the time of publication. However, as the medical
science is constantly changing and human error is always
possible, neither the author nor the others involved with the
publication of this book warrant that the information presented
here are absolutely accurate or complete, nor they are responsible
for omissions or errors in this book or for the results of using
this information. Readers are advised to confirm the information
contained in this book with other sources.
The other books by the author under Jaypee banner:
• Obstetric Drug Handbook, 1st edn 1998
• Gynaecology Drug Handbook, 1st edn 2001
• Practical Obstetrics, 1st edn 2003
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SECOND EDITION
AK Debdas
MD (Kol), FRCOG (Lond), FRCS (Edin), FICOG
Honorary Associate Professor
MGM Medical College, Jamshedpur
Visiting Consultant
Tinplate Hospital, Jamshedpur
Ex-Chairman
Practical Obstetrics Committee, FOGSI
Member
Governing Council
Indian College of Obstetrics and Gynaecology
Member
Journal Committee, FOGSI
Peer Reviewer
International Journal of Obstetrics and Gynaecology
Member
Representative Committee
Royal College of Obstetricians and
Gynaecologists of London - 4 terms
President
Indian Society of Perinatology and Reproductive Biology
Vice-President Elect
FOGSI
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Practical Cardiotocography
© 2005, AK Debdas
All rights reserved. No part of this publication should be reproduced, stored in a retrieval
system, or transmitted in any form or by any means: electronic, mechanical,
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author and the publisher.
This book has been published in good faith that the material provided by author is
original. Every effort is made to ensure accuracy of material, but the publisher,
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of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition : 1998
Second Edition : 2005
ISBN 81-8061-496-4
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., A 14, Sector 60, Noida
To
All women
Who must undertake
This serious responsibility
For the mankind

Preface to the Second Edition
CTG (Cardiotocography) has been in active clinical use for last forty
years and, as it appears from the current research situation, that it
will be continued to be used (please see Chapter 23—Beyond CTG).
This is because—no substitute matching its simplicity, ease, objectivity,
versatility, portability and price is anywhere in sight. In fact, due to
the above qualities, a user almost kind of gets hooked to it, and that
is why the use of CTG has greatly proliferated even in the developing
countries like India and has also lead to the birth of several indigenous
manufacturers of the machine in these countries. Who does not want
to practice scientific and transparent medicine?
The three major refinements that are now part of CTG technology
and which have improved interpretation and decision making on
CTG enormously are—the automatic computer analysis of tracing,
incorporation of STAN (ST analyser) software and vibroacoustic
stimulation test.
Happy ‘CTG ing’!
1st January, 2005 AK Debdas
Jamshedpur

Preface to the First Edition
Cardiotocography is here to stay for the foreseeable future (Carter
and Steer, 1993) if not for its positive benefit but certainly for want
of a better and simpler method than this of fetal monitoring. Past 25
years have seen phenomenal growth of its user specially in developed
countries—the machine now features even in the private chambers of
single handed Obstetricians.
Serial NSTs for high-risk antenatal cases and those with diminished
fetal movement is really the bare minimum objective antenatal fetal
care that one can give today. As regards fetal care in labour, a quick
FAST with CTG on admission in labour to sort out which fetus should
be monitored clinically which electronically (by CTG), which
continuously, which intermittently and which should be taken up
straight for caesarean section is gradually coming in vogue. And
hence, the pressing need for the obstetric staff—both doctors and
midwives to be thoroughly conversant with this investigative
technique.
The book is directed to the current user to help him or her to use
the machine to the fullest and finest extent and to the prospective
user to help to clear his or her doubt about the technique and
interpretation and also to help one make the right choice of machine
for one’s particular requirement. For postgraduate students it is a
must for strengthening their foundation and stimulating their
imagination and ingenuity.
I have tried to incorporate in this book my experience of this
method Since 1971, initially in UK and last 15 years in Telco Maternity
Hospital at Jamshedpur, India where I have been training doctors
and midwives in this technique for Indian College of Maternity and
Child health.
1st January, 1998 AK Debdas