PRE-INTERPRETATION QUALITY FAILURES IN INTRAPARTUM CARDIOTOCOGRAPHY: SIGNAL ADEQUACY AND MISSING UTERINE ACTIVITY IN A TERTIARY CENTRE

Abstract

Cardiotocography (CTG) is often discussed as a problem of classification: which guideline is used, how fetal heart rate patterns are categorized, and where the threshold for clinical escalation should lie. In practice, however, interpretation may already be compromised before a clinician reaches the classification stage. A technically poor recording can obscure baseline rate, variability or decelerations. Even when the fetal heart rate trace appears readable, interpretation may remain incomplete if uterine activity is not considered. This distinction is important because the timing of a deceleration in relation to a contraction is part of its clinical meaning, not an optional additional detail.