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Nursing QUESTION #9142
Question 1
During intrapartum monitoring, a CTG strip shows: baseline FHR 155 bpm, variability 2 bpm, late decelerations after each contraction recovering within 30 seconds. This CTG is classified as:
  • Normal/Reassuring
  • Suspicious/Non-reassuring
  • Pathological✔️
  • Technically unsatisfactory
Correct Answer Explanation

CTG classification is based on NICE (2022) / FIGO guidelines. Assess 4 features:

FeatureReassuringNon-reassuringAbnormalThis Strip
Baseline FHR110–160 bpm100–109 or 161–180<100 or >180155 bpm ✓ Reassuring
Variability5–25 bpm3–4 bpm (>30 min) or >25 bpm<3 bpm (>60 min) or sinusoidal2 bpm = Abnormal
DecelerationsNone or earlyVariable (typical)Late decelerationsLate = Abnormal
AccelerationsPresentAbsent—Not mentioned

Classification (NICE):

  • Normal: All 4 features reassuring
  • Suspicious: 1 non-reassuring feature
  • Pathological: ≥2 non-reassuring OR ≥1 abnormal feature

This CTG has: variability 2 bpm (abnormal) + late decelerations (abnormal) = PATHOLOGICAL

Action: Inform senior doctor immediately, consider fetal blood sampling (FBS), prepare for expedited delivery. Offer resuscitative measures: maternal lateral position, IV fluids, stop oxytocin.