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Cardiotocography (CTG) - What It Is & Why Do You Need It
The third trimester is a time that can be a filled with mixed emotions. You could be filled with excitement about the baby’s arrival and then be anxious about the baby’s health as well. What if something goes wrong at the last minute? Will everything go as planned? The cardiotocography is a technique that may help in alleviating some of your fears.
What is Cardiotocography?
A cardiotocography is a technique that is used to monitor the heartbeat of the foetus along with keeping a check on uterine contractions. This can be deciphered from the name itself - cardio (heart) toco (uterine contractions) and graph (recording). A CTG Test during pregnancy is usually performed during the third trimester as well as during labour. The correct utilization of this test can help prevent the baby from dying due to a shortage of oxygen.
Why Pregnant Women Need CTG
A CTG isn’t mandatory and low-risk pregnancies don’t require this. However, there are medical situations where the baby may be at risk such as:
Your blood pressure is on the higher side
You have been given medication to increase the speed of labour
You have been given an epidural to help you manage the pain during contractions
You have passed fresh blood during the labour process
You have ailments such as diabetes or hypertension
Your amniotic fluid is lower than the safe amount
You are expecting twins
There is a suspected reduction in placenta which may reduce the amount of blood your baby receives
You feel as though your baby’s movements are not the same, they have become erratic or slower than usual
Your baby is in an unusual position
Your temperature is on the higher side
The foetus has passed meconium (bowel movement) in the amniotic fluid. While this is not dangerous in itself, it can become dangerous if inhaled by the baby.
What Happens in Cardiotocography?
Internal Monitoring:This form of monitoring involves putting the device inside the vagina which means a certain amount of cervical dilation would be required. The device (an electrode) is placed close to the scalp of the foetus to get a reading. This form of monitoring is uncommon and is performed if there is difficulty in capturing the heartbeat in external monitoring. However, it is more accurate when compared to external monitoring and so may be the preferred method in complicated cases.
External Monitoring:This is the most common form of testing and is done by placing the equipment on the abdomen of the mother. It consists of an elastic belt with two round plate the size of a cricket ball. One plate emits an ultrasound frequency which is used to detect the baby’s heartbeat. The other plate is used to record the pressure on the mother’s abdomen along with the contractions. The belt is connected to a device that is used to read the signals that are being registered. Sometimes a gel may be applied to get a stronger signal. The reading by the device is given in the form of a loud beating sound. As some pregnant women can find this discomforting or distracting, there is a volume knob that can be used to lower the sound produced. Prior to going into labour, the mother would be asked to press a button on the machine each time she feels the baby move.
How Does CTG Work?
CTG employs sound waves to help detect and monitor your baby’s heartbeat. Soundwaves in the form of ultrasound are used for a variety of medical purposes such as locating solid gallstones or blood clots. When ultrasound is targeted in a direction, it moves freely through fluids and soft tissue. However, it bounces back when it hits any solid objects and this shows up on the recording device. With this, doctors are able to identify what is inside the body without opening it up. Additionally, it can differentiate between densities (meaning it can tell the difference between bones, muscles and other parts of the body). CTG employs Doppler, a type of ultrasound that helps in studying moving objects. This becomes relevant in detecting the heartbeat of the baby.
What Can Cardiotocography Show?
Baby’s have a higher than average heart rate of 110-160 heartbeats every minute. Anything higher or lower than that may be indicative of a problem in your baby’s health. The CTG helps detect anomalies that may occur during contractions. The heartbeat during this time has a set pattern and specific changes may be indicative of a problem. If your doctor is convinced that the issue may jeopardize the pregnancy, they would start an emergency caesarean section or assisted delivery.
Complications or Side Effects of CTG
CTG has two main advantages that have made it popular, namely its non-ionizing properties and its non-invasive nature. Unlike X rays, ultrasound does not employ any ionizing radiation to take a look inside the body. This means that you and your child will have no risk of genetic damage. Non-invasive means that the procedure does not introduce instruments inside the body. For example, a Caesarean is highly invasive.
However, CTG does have a few drawbacks such as:
Some of the CTG machine models offer poor mobility during labour which can be inconvenient.
Rampant use of CTG may lead to situations where Caesarean or assisted delivery may be done even though it may not be needed.
Pregnant women with contagious diseases such as HIV, Herpes and Hepatitis B risk passing on the infection to their child. In such cases, internal monitoring is strictly prohibited.
The reading is not precise and can even show a dead foetus as alive. This happens when the sensor captures the pulse of the mother’s abdominal aorta and mistakes it for a heartbeat.
How to Read CTG?
During CTG monitoring in pregnancy, the heart rate of the baby is constantly checked for any anomalies. The machine is equipped with a printer which allows you to have a look at the heart rate yourself. Below is a table which shows the range of what the registered values indicate.
Reading
Heart Beat per minute
Safe
110-160
Warning
100-109 or 161-180
Threatening
Lower than 100 or more than 180
However, an immediate action such as Caesarean or assisted delivery based on these readings isn’t always recommended. Your doctor would usually follow up with a biophysical profile of the foetus to be certain.
Please note that the readings are not precise so do not be alarmed if you find anomaly the first time. There could be a number of reasons such as your baby falling asleep during the test. In such instances, either the baby is woken up using a stimulator or the test is performed after a while. However, there may be instances when it can alert the doctor of a failing pregnancy. In such instances, an emergency procedure can be performed and save the life of your child.
Also Read: Doppler Sonography - All You Need To Know Read more
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One Bowl Cocoa Brownie
Be it kiddie birthday parties, unexpected visitors or your sudden sweet tooth craving, we bring you a quick fix for all of the possible ‘situations’ you could encounter. Meet the one bowl cocoa brownie with the added goodness of nuts!
Serves
Preparation Time
Cooking Time
4 People
10-15 Minutes
20-25 Minutes
Ingredients
300 g sugar
1 tsp vanilla extract
3 large eggs
120g plain flour
60g unsweetened cocoa powder
1 tsp fine salt
1/2 tsp baking powder
A handful of nuts of your choice
Method
Step 1
Roast the nuts slightly on a low flame and keep aside.
Step 2
Preheat your oven to 175 deg.
Step 3
In a bowl, stir together the sugar, butter, vanilla and eggs.
Step 4
Add to this the flour, cocoa, salt, baking powder and combine well. You can add a few chocolate chips if you like.
Step 5
Spread a little butter on abaking tin and spread the mixture in it.
Step 6
Bake the brownies at least for 25 minutes and check if the brownie is done. If not, bake for another 5 to 10 min.
Step 7
Sprinkle with more nuts, melted chocolate, white chocolate or fruits and serve.
Nutritional Information
Calories
637 K cal
Proteins
16.8 g
Fats
20.9 g
Carbohydrates
109.2 g
Cholesterol
140 mg
Sodium
693 mg
Potassium
507 mg
Tip: *For frying, add approximately 10 grams of fat per serving at 9 Kcal/gm of fat. Read more
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Onam – Celebrating The Essence of Kerala
Onam, originating from the Sanskrit word “Shravanam” or constellation, is celebrated with great fervour in Kerala and is the state's biggest and most awaited festival. This year, Onam will be celebrated on September 4. The importance of Onam celebration is such that holidays are declared across various organisations well in advance!
Every year, Malayalees in Kerala and across the world celebrate Onam to mark the homecoming of the Great King Mahabali. It also marks the harvest season for Kerala. The festival lasts for ten days, with the tenth day celebrated as Onam. With the year's festive season kicking off across the country, why not find out just how you too can join the celebrations?
The Mythology Behind Onam
Onam festival history is the perfect blend of mythology and tradition - the kind that makes great Indian legends. According to myths, Mahabali was a well-loved king and the greatest to have ever ruled Kerala. It is believed that he was sent to rule the underworld by the Vaman avatar of Lord Vishnu. Every year on a fixed day, he visits his subjects. His homecoming is celebrated as Onam or Thiruvonam.
Onam Celebration in Kerala – 5 Majestic Sights!
1. Flower Rangoli - Pookolam
Pookolam is the art of making beautiful designs with different types of flowers in the entryway of homes. During the ten days of the festival, a different flower layer is added to the Pookolam each day. Pookolams are made to give a beautiful welcome to Mahabali. Flowers such as marigold, rose and lotus are used to create stunning designs in yellow, orange, white, pink and purple. While new designs trend every year, traditional diyas, flowers and geometric patters are evergreen.
2. Banquet Lunch - Onasadya
A grand meal is prepared on the day of Thiruvonam and served on banana leaves. It is a nine course vegetarian meal with at least four vegetables. Some restaurants in Kerala offer as many as thirty dishes as Onasadya! For many families around the globe, Onasadya is a way to connect with friends and family. Not to forget, they get some lip-smacking pappadams (papad), payasams and uppilittathu (pickles)!
3. Snake Boat Race - Vallamkali
The Vallamkali or the snake boat race is a fun and entertaining way of celebrating Onam. Boat teams participate in the competitions organised across the state with about 150 men on each team. Trophies and prizes are distributed to the winning teams. Young men train and practise for the Vallamkali months in advance. After all, it is also considered a mark of strength and valour!
4. Folk Dances
Kerala is famous for its vibrant and expressive dance forms. The dance tradition gets infused with new life at this time. Kathakali and Kaikottikali are performed with renewed vigour to celebrate Onam. Thumbithullal – a dance performed by women in praise of their King Mahabali - is also very popular.
5. Elephant Procession
Elephants are an intrinsic part of Onam as a mark of royalty and richness. They are decorated in gold, flowers and other ornaments and taken around in a majestic procession around cities. People from all over the world gather to watch the spectacle. This is one thing that gets the kids really excited too!
The specialty of Onam is that the festival is celebrated by one and all in Kerala irrespective of their religion. The widespread global population of Malayalees comes up with unique Onam celebration ideas each year to cherish their tradition on this beautiful day. If you have been planning a trip to God's own country, there is no better time than Onam – a spectacular celebration of secularism and rich culture! Read more
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6 Things your Child Shouldn't Hear From you!
Children pick up words and phrases that they aren't supposed to. This could be courtesy – you! Wondering what not to say to your child? Well, something unflattering or negative that could affect their confidence while growing up!
If you're prone to making negative remarks about your kids, refrain from it. They don't need their parents telling them how bad they’ve been. Instead, explain things to them in a positive way.
6 Things Not to Say to Your Child
1. “You’re an idiot”
Ouch! This sentence could damage any kid’s confidence. Yes, your little one may be a little slow on the uptake but it doesn't merit a sentence so harsh. Take the time to explain things to him without going off the handle immediately.
2. “NO!”
A resounding ‘No’ can really get hurt your little one’s feelings. If you keep making negative comments, your kid will lose confidence. If you don't approve of a certain action, tell them how you feel about it in a positive manner. Give them options before you say a no.
3. “Go away, not now!”
All kids deserve attention. Make the time to hear your kid out when he has a query or a problem. If it's something that is bothering him, hearing the little one out can do him a world of good. A mom who gives her kids a patient hearing will always be able to solve his or problems.
4. “Why can’t you be like your brother?”
It is never a good idea to compare one sibling with the other. Accepting both kids, flaws and all, is vital for a healthy upbringing. Appreciate both kids for their individual qualities. When they are chastised separately, it doesn't affect them psychologically.
5. “Let Dad come back...”
“Daddy will come home and take you to task.” While it may instil fear in him, it'll reduce your authority. There could come a time where he would not even heed the warnings you give. Using dad as a threat could be quite ineffective when he is out on a business trip. During this time, you may not get your kid to even listen to you. Therefore, it's best for the little one to know who the boss is from the get-go. Dad can be used as a secondary threat.
6. “Why did I get a kid like you?”
All parents have trouble with their kids when they are just learning how to walk and talk. If your kid is misbehaving, don't come down on him badly. This is because his behaviour could be a reflection of the environment he is growing up in. Change how you interact with your husband and others living in the house. Order brings order. This is definitely one of the things not to say to your kids.
As a mom, your job would be to nurture and care for your child. Give them the confidence they need to face any challenge life throws at them. Low morale or negative words could chip at their confidence. Watch what you speak around your kids, ladies!
Is there any phrase that you avoid saying to your child? Why? Tell us in the comments and let's help each other become better parents! Read more
Akifa Tahreem has added a new answer
Expecting Mom due in 7 months
9 hours ago
Q. hello doctor, I'm 3 weeks pregnant. can we sleep on our belly or which side We can sleep on during pregnancy...
Akifa Tahreem
Mom of a 7 m old boy
7 hours ago
A. no you can't sleep in your tummy
Dr Laxmi Chavan-Sawant has added a new answer
Trying To Conceive
6 hours ago
Q. @ask_the_expert
#ask the expert
I am having pcod problem.
when should I check pregnancy test at home?
Dr Laxmi Chavan-Sawant
Ayurvedic Gynaecologist
4 hours ago
A. If you have missed your periods you can wait for one week more and then do a urine pregnancy test to know about the pregnancy result and consult with your doctor according to the result for medication
Dr Priyanka Kalra has added a new answer
Trying To Conceive
6 hours ago
Q. I am having pcod problem.
At which day should I take pregnancy test
Dr Priyanka Kalra
Obstetrician and Gynaecologist
3 hours ago
A. after 2 weeks. do ultrasound n necessary tests after consulting a specialist. without proper check up we can't advise or help you.. Avoid shirt cuts when it comes to health if mother n baby. ok.
Dr Laxmi Chavan-Sawant has added a new answer
Trying To Conceive
6 hours ago
Q. I am having pcod problem.
when should I take pregnancy test?
Dr Laxmi Chavan-Sawant
Ayurvedic Gynaecologist
4 hours ago
A. after missed your periods you can wait for one week more ,then you can do a urine pregnancy test to know about the pregnancy result and consult with your doctor according to the result for medication
Dr Laxmi Chavan-Sawant has added a new answer
Trying To Conceive
5 hours ago
Q. I am having pcod problem.
but having regular cycles below 35 days. some time it will extended upto 40 days.
so when should I take pregnancy test at home?
Dr Laxmi Chavan-Sawant
Ayurvedic Gynaecologist
4 hours ago
A. If you have missed your periods you can wait for one week more or else you can do a urine pregnancy test to know about the pregnancy result and consult with your doctor according to the result for medication.
The best treatment to have Regular periods is by having a healthy lifestyle with regular daily walking or jogging along with mild exercise and meditation whenever possible. as medications will only act till you are taking them
Dr Ghouse has added a new answer
Expecting Mom due this month
2 hours ago
Q. Done my first routine blood test ..it shows thyroid border line.its my 6 week running as per USG.
but prior to that my thyroid level was always normal I did check up every year and got it normal .this time it shows borderline high in 6 week pregnancy.
is it something to worry.plz guide
Read moreDr Ghouse
Paediatrician
1 hour ago
A. it is better to follow your doctors advice for treating the thyroid deficiency. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
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