Monitoring the heartbeat and labor

introduction

A Labor recorder is a technical process with which both the childlike heart activity as well as the Labor can be recorded in pregnant women.
The term der is also synonymous Cardiotocography (short: CTG), which is derived from the Greek word tokos (= labor).

This method is used on the one hand in the context of Checkups during pregnancy and for another monitoring of Birth process used.

The heart activity of the unborn child is measured using Doppler ultrasound and recorded as the heart rate. The unit here is beats per minute.
The mother's labor activity is measured with the help of a pressure sensor, which registers the change in the circumference of the abdomen during a labor.
Depending on the physical constitution of the pregnant woman, the pressure measurement can vary and not provide very accurate values.
Therefore, in addition to the actual measurement, the subjective feeling about the perception of labor by the pregnant woman is also important.

The mother-to-be should ideally lie on her side or on her back for the duration of the examination. Usually two belts are placed around her stomach, which are supposed to hold the respective measuring sensors on the abdominal wall. As a rule, the sensors are connected to the actual device for recording via a cable.
The measured data can be printed there on paper strips. With modern devices, data transmission is also possible via radio, so that the woman can move freely during the examination.

The contraceptive recorder is primarily used to monitor the child's heartbeat.
These correlate directly with the oxygen supply to the unborn child, which is essential for physical development.
If the heart rate drops, for example, this is to be interpreted as a direct sign of an insufficient supply of oxygen and should be remedied as quickly as possible so as not to endanger the health of the unborn child.

This examination is usually only carried out from the 30th week of pregnancy.
As a rule, it is repeated every 14 days as part of the usual preventive examinations if there are no other abnormalities.
In the case of certain risk constellations or complications in pregnancy, however, it can be useful to carry out a CTG examination earlier or at shorter intervals.

According to maternity guidelines, a prenatal CTG examination is only indicated if premature birth is expected or other risk constellations are present.

By default, however, this examination should be performed on all women during childbirth.

Read more about the contraction recorder at: CTG

Standard values

Both the childlike heart activity as well as the maternal labor recorded.

The child's heart activity is given as heart rate in beats per minute.
Usually it should between 110 to 150 beats per minute (also: beats per minute, short: bpm) lie.
Towards the due date, this can even increase a little, usually up to 160 bpm.
The basic frequency corresponds roughly to the resting heart rate of the adult and is referred to as the baseline in contractions.
Values ​​below 110 bpm medically correspond to bradycardia, Values ​​above 150-160 bpm one Tachycardia.

During the investigation, the Baseline fluctuations (Oscillations) and whether it changes over longer time intervals (accelerations / decelerations).

The heart rate is not always constant, even in unborn babies, but should not be more than about 15-20 bpm from one Average frequency differ.
On the CTG curve, this phenomenon is expressed as a curve with small peaks. If, on the other hand, the heart rate were always constant at one value, you would have a straight line.
Usually these occur Oscillations especially at Changes in the child's situation on. On average, should per minute the CTG recording, for example three to five such Oscillations be measured.

A prolonged increase in the basic frequency is in the CTG as acceleration referred to, a Slowdown however as Deceleration.
It is important that the Change in baseline more than 15 bpm and lasts longer than 15 seconds.
Accelerations are also a sign of liveliness and healthy activity of the child. Normally should be about 2 accelerations per 30 minutes CTG measurement occur.

Decelerations, so a slowdown in heart rate are also synonymous as Dips designated. Depending on the size of the waste, synchronicity with contractions and the duration of the decelerations, a distinction is made between different levels.
Are the dips more likely irregular, just last short (less than half a minute) and kick regardless of labor on, they are considered complete harmless to classify.
Decelerations that are about synchronized with the start of labor also occur as good sign and indicate that the child is responding well to labor.
However, if the dips are delayed or take longer, this can be a sign that the Child not enough With oxygen is supplied and possibly a Induction of labor should be considered.

The Labor becomes as tension on the abdominal wall measured, which usually changes during contraction during labor.
However, depending on physical constitution of the mother this measurement is not always very precise, which is why the subjective feeling of the woman is too is very important for the assessment.
On the CTG recording you can then Size, regularity and duration of labor further assess.

When should measurements begin?

In principle, a labor recorder is more for them monitoring of the advanced pregnancy or the birth process makes sense.
When threatening Premature birth or Risk constellations the mother like a Diabetes mellitus, high blood pressure, infections, vaginal bleeding or Ultrasound abnormalities in the child a CTG examination should already be carried out from the 25th week of pregnancy respectively.

Otherwise inconspicuous course of pregnancy the cardiotocogram (short: CTG) is mostly from the 30th week of pregnancy carried out as part of the preventive medical check-ups and repeated every 14 days until the due date.

It comes to Transmission of the unborn, i.e. the continuation of the pregnancy after the calculated delivery date, the CTG examination should also be performed in shorter time intervals be repeated.

Before the birth itself will routinely a Cardiotocogram (short: CTG) made in order to better monitor the child's condition before birth.
In particular, it measures to what extent the child reacts to labor and whether it has properly adjusted to the imminent birth.
Usually then about two hours apart one each 30 minute cardiotocogram (short: CTG) recorded.

During labor

A good sign for one Uncomplicated spontaneous delivery is when the child responds well to the mother's labor.

During one Woe it comes to Compression of the abdomen the mother, so that the blood supply and thus the oxygen supply of the child is temporarily cut off.

If the contraction is severe enough, a deceleration of the child's heart rate can be observed in the CTG at the beginning of the contraction. The baseline should reach its lowest value around the peak of the contraction. Because after all, an unborn child's first reaction to one is Insufficient supply of oxygen always one Lowering the heart rate.
However, this deceleration should reverse quickly and the child's baseline should rise to its initial value.

If it does not do this or if the deceleration occurs only after a delay, this should definitely be further observed, as this could be an indication of an insufficient supply of oxygen to the child.
In the worst case, a emergency caesarean section be necessary in order not to endanger the child's health any further.

Heart sounds

With the help of childish heartbeat is the cardiotocogram (short: CTG) the Heart rate of the unborn child.
This is done technically with the help of a Doppler ultrasound, from which a signal is sent out and the time is measured until the signal is reflected by the child's heart and returned to the sensor. The time difference can then be used to calculate how quickly the child's heart activity is up-to-date. The measuring sensor is usually a Special microphone, which is also known as a Doppler ultrasound transducer.

The advantage of this method is that one "Live" monitoring the child can be done from the outside through a completely non-invasive procedure.
However, as a result of the indirect measurement, the method is also particularly susceptible to the smallest disturbances, such as movements of the child or mother.
So it is important to have a CTG examination at least one for half an hour to be carried out continuously in order to obtain a meaningful overall overview.
Ideally, the mother should also lie down as calmly and relaxed as possible and not move much during the examination.

Overall, however, the contraceptive recorder is a very good examination method with which the unborn child can be monitored from the outside relatively easily and completely painlessly.