CTG Drill

Rapid-fire cardiotocography under the clock — but you commit to an action, not a category.

A tracing appears. The timer runs. You don't classify it — you decide what to do. Twelve cases, a streak multiplier, and a clock you set yourself below. Because a Category II that's on oxytocin and a Category II that isn't are the same category and a different decision.

Your six commitments

1Continue monitoring — reassuring trace, no intervention
2Conservative measures — reposition, IV fluids, treat the reversible cause
3Stop / reduce oxytocin — when the uterotonic is driving it
4Acute tocolysis — terbutaline for tachysystole not from oxytocin
5Fetal scalp stimulation — elicit an acceleration to assess status
6Expedite delivery — escalate, call for help, deliver

Seconds per case

Scoring: faster correct answers score higher. Consecutive correct calls build a multiplier up to 3×. A wrong call or a timeout breaks the streak. Some near-misses earn partial credit with a nudge toward the better first move. On desktop, press 1–6.

Evidence base — same logic as CTG Navigator

  1. American College of Obstetricians and Gynecologists. Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol. 2009;114(1):192–202. Three-tier Category I/II/III system; intrauterine resuscitation; oxytocin management.
  2. Macones GA, Hankins GD, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring. Obstet Gynecol. 2008;112(3):661–666. Standardized CTG definitions and pattern nomenclature.
  3. Ayres-de-Campos D, Spong CY, Chandraharan E; FIGO Intrapartum Fetal Monitoring Expert Consensus Panel. FIGO consensus guidelines on intrapartum fetal monitoring: cardiotocography. Int J Gynaecol Obstet. 2015;131(1):13–24. Normal / Suspicious / Pathological; international consensus.
  4. National Institute for Health and Care Excellence. Fetal monitoring in labour. NICE guideline NG229. 2022. Prolonged deceleration ≥3 min threshold; sepsis exception to scalp stimulation.