NexGene AI
Workshop edition

21 cases. One way to read a CTG.

Open a case, walk through the trace one finding at a time, finish with verdict and management. Antepartum NST and intrapartum CTG, normal through pathological.

Antepartum / NST (6)

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Normal6 steps

Normal reactive NST at term

The reassuring template — anchor your eye here first.

39+1 weeks · Routine post-dates surveillance
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Suspicious6 steps

Non-reactive trace — likely fetal sleep

Normal baseline and variability, but no accelerations.

37+4 weeks · Routine screening, diet-controlled GDM
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Suspicious6 steps

Reduced variability at term — needs escalation

Flat trace, no accelerations — not just sleep.

40+5 weeks · Reduced fetal movements ×24 h
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Pathological5 steps

Antenatal bradycardia — find the cause

Baseline 95 bpm in clinic — emergency or congenital?

36+0 weeks · Routine antenatal clinic visit
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Pathological6 steps

Sinusoidal pattern — recognise immediately

Smooth sine wave, no true variability, no accelerations.

34+1 weeks · Reduced fetal movements 24 h, mild PV bleed
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Suspicious5 steps

Antepartum variable decels — oligohydramnios

Variables without contractions point to cord at risk.

36+3 weeks · Surveillance for IUGR with oligohydramnios (AFI 4)

Intrapartum CTG (15)

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Normal7 steps

Reassuring intrapartum CTG

Normal labour trace — FIGO Normal across all features.

40+0 weeks, in labour · Spontaneous active labour, 6 cm dilated
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Normal6 steps

Early decelerations — head compression

Mirror image of contractions — benign.

39+3 weeks, second stage · Pushing for 30 min, vertex at +1
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Suspicious6 steps

Variable decels — cord compression

Abrupt drops with each contraction, no concerning features.

40+2 weeks, active first stage · 5 cm dilated, membranes ruptured 2 h, clear liquor
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Pathological6 steps

Variable decels WITH concerning features

Deep, prolonged, slow recovery — escalate.

40+5 weeks, active labour · 7 cm, ARM 1 h ago, clear liquor initially
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Pathological7 steps

Recurrent late decelerations

Nadir AFTER the contraction peak — uteroplacental insufficiency.

39+0 weeks, IOL for pre-eclampsia · Oxytocin 12 mU/min
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Pathological6 steps

Tachycardia + reduced variability — chorioamnionitis

Two concerning features combine in a sick mother.

38+5 weeks, in labour · ROM 18 h, maternal temp 38.4 °C
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Pathological5 steps

Tachysystole on oxytocin

Too many contractions — fetal reserve depleting.

40+1 weeks, IOL · Oxytocin 18 mU/min, ARM 4 h ago
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Pathological4 steps

Prolonged deceleration — acute event

FHR <100 for >3 min. Find the cause now.

39+4 weeks, active labour 8 cm · ARM 30 min ago, clear liquor
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Pathological4 steps

Second-stage bradycardia with pushing

Common in second stage — when do you intervene?

40+0 weeks, second stage · Active pushing 45 min, vertex at +2
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Suspicious5 steps

Maternal pulse mistaken for fetal

Beautiful trace, wrong heart. Always confirm the source.

39+2 weeks, active labour · External transducer; epidural in situ
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Pathological6 steps

Pre-terminal trace

Absent variability + recurrent late decels — deliver now.

40+3 weeks, prolonged second stage · Thick meconium liquor, no progress for 2 h
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Pathological4 steps

Post-epidural late decels — reversible

Pathological trace, treat the cause first.

39+5 weeks, active labour · Epidural top-up 10 min ago
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Pathological5 steps

VBAC trace — suspect uterine rupture

New bradycardia + abnormal contractions in a scarred uterus.

40+0 weeks, VBAC in labour · 6 cm, oxytocin augmentation
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Suspicious4 steps

Twin trace — signal coincidence

Two channels, one heart — always check separation.

37+0 weeks, DCDA twins in labour · Twin 1 cephalic, twin 2 transverse
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Suspicious4 steps

Increased variability (saltatory pattern)

Bandwidth >25 bpm for >30 min — under-recognised warning.

40+1 weeks, active labour · 8 cm, no oxytocin
Tracings are synthetic, generated deterministically from clinical parameters — no patient data. Add ?present=1 to any case URL for presenter mode. See the reference page for criteria and glossary.