By the end of this chapter, you will be able to:
Mastering these skills ensures the CTG machine works safely and reliably, helping healthcare professionals provide the best care for mothers and babies.
Maternity care in Kenya relies heavily on advanced biomedical equipment to monitor both maternal and fetal wellbeing during pregnancy and labor. The Cardiotocography (CTG) machine is a critical device used in healthcare facilities such as county hospitals, maternity clinics, and referral centers to continuously assess fetal heart rate and uterine contractions. Biomedical engineers play a vital role in maintaining CTG machines to ensure accurate monitoring, which informs clinical decisions and improves birth outcomes. This chapter explores the use, components, and maintenance considerations of the CTG machine within the Kenyan biomedical engineering context.
The CTG machine is an essential tool in maternity wards across Kenya, assisting healthcare providers to monitor fetal health and uterine activity non-invasively. It provides real-time data that helps detect fetal distress, guiding timely interventions that can prevent complications during labor. Understanding the operational principles and clinical applications of CTG machines enables biomedical engineers to support effective maternal and fetal monitoring by ensuring device reliability and accuracy.
The primary purpose of the CTG machine is to continuously record the fetal heart rate and uterine contractions, providing a visual trace that clinicians interpret to assess fetal wellbeing during pregnancy and labor. This monitoring helps identify abnormal fetal heart patterns that may indicate hypoxia or distress, allowing for prompt medical intervention such as cesarean delivery or assisted labor. In Kenya’s public hospitals, CTG monitoring is critical in managing high-risk pregnancies, reducing neonatal morbidity and mortality.
CTG machines are used in diverse clinical settings including maternity wards in county hospitals, private clinics, and referral hospitals. In high-volume facilities such as Moi Teaching and Referral Hospital, continuous CTG monitoring is standard practice for women in labor with risk factors like hypertension or diabetes. In smaller rural clinics, intermittent CTG monitoring is often employed due to limited resources, but biomedical engineers must ensure that machines are functional and calibrated for accurate readings whenever used.
The CTG machine produces two main traces: the fetal heart rate (FHR) and uterine contraction pattern. Biomedical engineers must understand the basics of trace interpretation to troubleshoot issues such as signal loss or artifact interference. For instance, a normal FHR ranges between 110 and 160 beats per minute, with variability indicating fetal health. Decelerations or prolonged bradycardia on the trace may signal fetal distress, necessitating immediate clinical attention. Proper functioning of the CTG machine ensures that these critical patterns are accurately captured.
Biomedical engineers support clinicians by maintaining CTG machines to guarantee accurate and continuous monitoring. This includes regular calibration, software updates, and prompt repair of faulty components. For example, at Kenyatta National Hospital, biomedical engineering teams conduct routine CTG machine checks to prevent downtime during labor monitoring. Engineers also provide user training to clinical staff on correct probe placement and device handling to minimize errors in data acquisition.
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Create a free accountThis chapter provided a comprehensive overview of the cardiotocography (CTG) machine, emphasizing its critical role in monitoring fetal well-being during pregnancy and labor. The discussion began with the use of the CTG machine to record fetal heart rate and uterine contractions, essential for assessing fetal health. It then detailed the main parts of the CTG machine, including transducer probes that detect signals, the monitor that displays readings, and the Doppler device used for detecting fetal heart sounds. The principle of operation was explained through various fetal monitoring techniques that rely on interpreting the electrical and mechanical signals from the fetus and uterus. Fault diagnosis covered common issues that may arise with the machine and methods to identify them to ensure continuous accurate monitoring. Maintenance procedures were outlined to keep the CTG machine functioning optimally, with particular attention given to calibration procedures that verify the accuracy and reliability of the device. Together, these components and practices form the foundation for effective use and upkeep of CTG machines in maternity care settings.
Type: Individual
| Tools & Equipment | Materials |
|---|---|
| Screwdriver | Gloves |
| Masking Tape | 70% Alcoholic Disinfectant |
| Service Sticker |
| S/N | Item | Quantity |
|---|---|---|
| 1 | Cardiotocography (CTG) Machine Unit | 1 Pc per Candidate |
| 2 | Fetal Transducer Probe | 1 Pc per Candidate |
| 3 | Uterine Contraction Transducer Probe | 1 Pc per Candidate |
| 4 | Doppler Ultrasound Probe | 1 Pc per Candidate |
| 5 | Monitor Display Unit | 1 Pc per Candidate |
| 6 | Connecting Cables and Clips | 1 Set per Candidate |
| 7 | Gloves | 2 Pairs per Candidate |
| 8 | Screwdriver | 1 Pc per Candidate |
| 9 | Masking Tape | 1 Piece per 10 Candidates |
| 10 | Service Sticker | 1 Pc per Candidate |
| 11 | 70% Alcoholic Disinfectant | 100 ml per Candidate |
| Items to be Evaluated | Marks Available | Marks Obtained | Comments |
|---|---|---|---|
| TASK 1: WEAR PPE AND PREPARE WORK AREA | |||
| Wore gloves (Award 1 mark for wearing gloves or 0) | 1 | ||
| Sub-Total | 1 | ||
| TASK 2: IDENTIFY AND LABEL CTG MACHINE PARTS | |||
| Correctly identified the CTG machine unit (Award 1 mark for correct identification) | 1 | ||
| Identified and labeled fetal transducer probe (Award 1 mark for correct labeling) | 1 | ||
| Identified and labeled uterine contraction transducer probe (Award 1 mark for correct labeling) | 1 | ||
| Identified and labeled Doppler ultrasound probe (Award 1 mark for correct labeling) | 1 | ||
| Identified and labeled monitor display unit (Award 1 mark for correct labeling) | 1 | ||
| Sub-Total | 5 | ||
| TASK 3: ASSEMBLE CTG MACHINE PARTS CORRECTLY | |||
| Selected correct tools for assembly (Award 1 mark for correct tool selection) | 1 | ||
| Connected fetal transducer probe to the correct port (Award 2 marks for correct connection and secure fitting) | 2 | ||
| Connected uterine contraction transducer probe correctly (Award 2 marks for correct connection and secure fitting) | 2 | ||
| Connected Doppler ultrasound probe properly (Award 2 marks for correct connection and secure fitting) | 2 | ||
| Connected monitor display unit and powered on machine correctly (Award 2 marks for correct connection and power on) | 2 | ||
| Used masking tape to label parts clearly (Award 1 mark for clear labeling) | 1 | ||
| Sub-Total | 10 | ||
| TASK 4: TEST AND CLEAN THE ASSEMBLED MACHINE | |||
| Performed functionality test by powering on and checking display (Award 2 marks for successful operation and display reading) | 2 | ||
| Cleaned and disinfected external surfaces using 70% alcoholic disinfectant (Award 2 marks for proper cleaning and disinfection) | 2 | ||
| Filled service sticker correctly with date, machine name, tasks performed, and observations (Award 2 marks for complete and accurate service sticker) | 2 | ||
| Sub-Total | 6 | ||
| PRODUCT CHECKLIST | |||
| All CTG machine parts correctly identified, labeled, and assembled with secure connections and functional operation (Award 10 marks for complete and correct assembly and functionality) | 10 | ||
| Sub-Total | 10 | ||
| GRAND TOTAL | 32 | ||
Type: Individual
| Tools & Equipment | Materials |
|---|---|
| Ultrasound transducer probe | Functional CTG machine |
| Tocotransducer probe | CTG paper rolls |
| Surgical mask | Conductive gel |
| Surgical cap | Alcohol-based disinfectant |
| Dust coat/lab coat | Writing materials |
| Safety boots | |
| Disposable gloves | |
| Cleaning cloths |
| S/N | Item | Quantity |
|---|---|---|
| 1 | Functional CTG machine | 1 Pc per 2 Candidates |
| 2 | Ultrasound transducer probe | 1 Pc per Candidate |
| 3 | Tocotransducer (pressure) probe | 1 Pc per Candidate |
| 4 | CTG paper rolls | 1 roll per Candidate |
| 5 | Conductive gel | 50 ml per Candidate |
| 6 | Disposable gloves | 2 pairs per Candidate |
| 7 | Surgical mask | 1 Pc per Candidate |
| 8 | Surgical cap | 1 Pc per Candidate |
| 9 | Dust coat/lab coat | 1 Pc per Candidate |
| 10 | Safety boots | 1 Pc per Candidate |
| 11 | Alcohol-based disinfectant | 100 ml per Candidate |
| 12 | Cleaning cloths | 2 Pcs per Candidate |
| 13 | Writing materials | 1 set per Candidate |
| Items to be Evaluated | Marks Available | Marks Obtained | Comments |
|---|---|---|---|
| TASK 1: PPE and Preparation | |||
| Wore all required PPEs: dust coat/lab coat, surgical mask, surgical cap, safety boots, gloves (Award 1 mark for all PPE worn, else 0) | 1 | ||
| Prepared CTG machine and inspected for cleanliness and functionality (Award 1 mark for proper inspection and preparation) | 1 | ||
| Applied conductive gel correctly on ultrasound transducer probe (Award 1 mark for correct application of gel) | 1 | ||
| Set up CTG paper roll correctly in the machine (Award 1 mark for correct paper loading) | 1 | ||
| Connected ultrasound and toco transducer probes properly to the CTG machine (Award 1 mark for correct connection of probes) | 1 | ||
| Sub-Total | 5 | ||
| TASK 2: Operation and Monitoring | |||
| Positioned probes correctly on the patient’s abdomen for foetal heart rate and uterine contraction monitoring (Award 2 marks for correct placement and positioning) | 2 | ||
| Turned on CTG machine and selected appropriate settings (e.g., paper speed 1 cm/min or 2 cm/min) (Award 1 mark for correct settings) | 1 | ||
| Monitored and recorded foetal heart rate and uterine contractions continuously for 30 minutes (Award 3 marks for continuous and accurate monitoring) | 3 | ||
| Read and interpreted the CTG printout correctly during monitoring (Award 2 marks for correct interpretation) | 2 | ||
| Sub-Total | 8 | ||
| TASK 3: Post-Monitoring Procedures | |||
| Switched off CTG machine and disconnected probes carefully (Award 1 mark for proper shutdown and disconnection) | 1 | ||
| Cleaned and disinfected probes and external machine surfaces using appropriate disinfectant (Award 2 marks for thorough cleaning and disinfection) | 2 | ||
| Disposed of used gloves and cleaning materials properly (Award 1 mark for proper disposal) | 1 | ||
| Completed monitoring records accurately including date, patient ID, duration, and observations (Award 2 marks for complete and accurate documentation) | 2 | ||
| Sub-Total | 6 | ||
| PRODUCT CHECKLIST | |||
| CTG printout shows clear, continuous foetal heart rate and uterine contraction traces over 30 minutes (Award 4 marks for clear and continuous recording) | 4 | ||
| Correct placement and connection of probes verified by quality of printout (Award 3 marks for correct probe placement as evidenced by printout quality) | 3 | ||
| Monitoring records correctly filled with all required information (Award 3 marks for complete and legible records) | 3 | ||
| Sub-Total | 10 | ||
| GRAND TOTAL | 29 | ||
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