 Cardiotocography (simultaneous recording of fetal heart rate (FHR) and uterine

contractions) is one of the most used diagnostic techniques to evaluate fetal well-being and
to investigate the functional state of the fetal autonomic nervous system.
 Abdominal electrocardiograms and Doppler ultrasound techniques such as cardiotocography
(CTG) are generally used as external modes of monitoring
 These are considered external because the relevant signal is recorded from the mother's
abdomen. On the other hand, fetal scalp electrodes (FSE) are utilized for internal mode of
monitoring. In the later mode, fetal cardiac signals are captured through fetal scalp.
 The FHR is extracted from the abdECG and FSE signals through electrical activity of fetal
heart using fetal electrocardiograms (fECG), while Doppler ultrasound techniques are used
to extract FHR through ultrasoundwaves reflected from fetal heart movements. The
extracted FHR is further analysed for assessment of the fetal condition
 The basal level of FHR signal, FHR variability, and temporal changes of FHR such as acceleration
and deceleration are the basic parameters according to the guidelines.
 The baseline expresses the mean FHR value when accelerations and deceleration patterns are
isolated from the signal
 FHR variability indicates the beat-to-beat effect of fetal sympathetic and parasympathetic
nervous systems and existing of this variability points the fetal welfare while the absence or
weakness of the variability is associated with adverse conditions such as umbilical cord
compression, fetal hypoxia or fetal acidaemia.
 As for transient changes of FHR, accelerations are adopted as the desired patterns and point the
fetal movements whereas decelerations indicate the stressful conditions