Preliminary Pages

1PRACTICAL CARDIOTOCOGRAPHY2

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

3PRACTICAL CARDIOTOCOGRAPHY

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

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, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.

First Edition : 1998

Second Edition : 2005

9788180614965

Typeset at JPBMP typesetting unit

Printed at Gopsons Papers Ltd., A 14, Sector 60, Noida

7Preface 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

Jamshedpur

AK Debdas

9Preface 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

Chapter Notes