Reference
Frameworks and glossary for workshop attendees. Bookmark this page for quick lookup during cases.
Three frameworks, one tracing
FIGO 2015
International consensus
Three categories: Normal · Suspicious · Pathological.
Baseline
| Normal | 110–160 bpm |
| Suspicious | 100–109 or 161–180 bpm |
| Pathological | <100 or >180 bpm |
Variability
| Normal | 5–25 bpm |
| Suspicious | <5 for >50 min or >25 for >30 min |
| Pathological | Absent, or sinusoidal ≥30 min |
Decelerations
| Normal | Absent or early |
| Suspicious | Repetitive variable, mild–moderate |
| Pathological | Repetitive late, prolonged >3 min, deep variables |
NICE
UK National Institute for Health and Care Excellence
Per-feature: Reassuring · Non-reassuring · Abnormal. Overall: Normal / Suspicious / Pathological.
Baseline
| Reassuring | 110–160 bpm |
| Non-reassuring | 100–109 or 161–180 |
| Abnormal | <100 or >180 |
Variability
| Reassuring | 5–25 bpm |
| Non-reassuring | <5 for 30–50 min |
| Abnormal | <5 for >50 min |
Decelerations
| Reassuring | None / early |
| Non-reassuring | Variables without concern |
| Abnormal | Deep / late / prolonged |
Accelerations
| Reassuring | Present (≥2 in 20 min) |
DR C BRAVADO
Structured reading mnemonic
Read every CTG in the same order, every time.
- DR — Define Risk (maternal & fetal context)
- C — Contractions (frequency, duration)
- BRA — Baseline RAte
- V — Variability
- A — Accelerations
- D — Decelerations
- O — Overall impression
Great for handovers and structured documentation.
Glossary
- NST
- Non-Stress Test. Antenatal recording of fetal heart rate without external stress, used to assess fetal wellbeing.
- CTG
- Cardiotocograph. Continuous recording of fetal heart rate (top channel) and uterine activity (bottom channel).
- Baseline FHR
- Mean FHR over 10 min, excluding accelerations and decelerations. Normal 110–160 bpm.
- Variability
- Peak-to-peak bandwidth of FHR around the baseline. Moderate (6–25 bpm) is reassuring.
- Acceleration
- Abrupt rise in FHR ≥15 bpm for ≥15 s. Reactive NST = ≥2 in 20 min.
- Early deceleration
- Symmetric, gradual decrease, nadir coincides with peak of contraction. Head compression — benign.
- Variable deceleration
- Abrupt decrease (onset to nadir <30 s), variable timing relative to contractions. Cord compression.
- Late deceleration
- Symmetric, gradual decrease with nadir AFTER the contraction peak. Uteroplacental insufficiency — concerning.
- Prolonged deceleration
- Decrease in FHR ≥15 bpm lasting ≥2 min but <10 min. ≥3 min = fetal emergency.
- Sinusoidal pattern
- Smooth, regular sine-wave undulation at 3–5 cycles/min, amplitude 5–15 bpm, no accelerations, persisting ≥30 min (FIGO 2015). Suggests severe fetal anaemia.
- Tachysystole
- >5 contractions in 10 min averaged over 30 min.
- Reactive NST
- ≥2 accelerations of ≥15 bpm for ≥15 s within 20 min.
- DR C BRAVADO
- Mnemonic: Define Risk · Contractions · Baseline RAte · Variability · Accelerations · Decelerations · Overall.