KARDIOTOKOGRAFI

oleh

Yusrawati
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Category I: NORMAL
 FHR tracings include ALL of the following:
 Baseline rate: 110–160 beats per minute (bpm)
 Baseline FHR variability: moderate
 Late or variable decelerations: absent
 Early decelerations: present or absent
 Accelerations: present or absent
 Strongly predictive of normal acid-base status at time
of observation.
 Routine care; no specific action required

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Category III: ABNORMAL
 FHR tracings include EITHER of the ff:
 Absent baseline FHR variability and any of the ff:
 Recurrent late decelerations
 Recurrent variable decelerations
 Bradycardia
 Sinusoidal pattern

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Category II: INDETERMINATE
 includes all FHR tracings NOT categorized as
Category I or III.
 tracings may represent an appreciable fraction of those
encountered in clinical care.
 NOT predictive of either normal or abnormal fetal
acid-base status.
 requires continued surveillance and re-evaluation-
second recommendation is incomplete

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  Grades of fluctuation are based on amplitude range
(peak minus trough):

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Classifications of Variability
 Absent: amplitude range undetectable.
 Minimal: amplitude range ≤5 bpm.
 Moderate: amplitude range 6-25 bpm.
 Marked: amplitude range >25 bpm.

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  Persistently minimal or absent FHR variability
appears to be the most significant intrapartum
sign of fetal compromise.
 On the other hand, the presence of good FHR
variability may not always be predictive of a good
outcome.

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BASELINE FHR PATTERNS
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 110 BPM

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 160 BPM

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 From the onset of the deceleration to
the beginning of the FHR nadir of
<30 seconds.

The decrease in FHR is ≥15 beats

per minute, lasting ≥15 seconds, and
<2 minutes in duration

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Variable Decelerations
 Severe
 ≥ 60 seconds in duration & < 70 beats/min OR
 ≥ 2 mins in duration & < 80 beats/min
 Moderate
 30-60 sec in duration & < 70 beats/min OR
 ≥ 60 sec in duration & < 80 beats/min
 Mild
 All other decelerations are mild

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Variable Decelerations - Notice that the decelerations are not related to the contraction,
beginning
8/20/2018 well before the mcu
contraction
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 from the onset to the nadir of the
deceleration of ≥30 seconds.

The nadir of the deceleration occurring

after the peak of the contraction.

In most cases, the onset, nadir, and

recovery of the deceleration occur after
the beginning, peak, and ending of the
contraction, respectively.

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Late Deceleration with Absent Variability –
Notice the decrease in the fetal heart rate only begins to decline after the contraction
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peaks.
 from the onset to the FHR nadir of ≥30
seconds.

The nadir of the deceleration occurs at

the same time as the peak of the
contraction.

n most cases the onset, nadir, and

recovery of the deceleration are
coincident with the beginning, peak,
and ending of the contraction,
respectively.
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Pseudo-sinusoidal Pattern
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Thank you!