Abstract

Introduction: On the CTG, variability reflects the oxygenation of the CNS. Increased baseline variability at >25 bpm is called “Saltatory Pattern” (SP) and has been considered as a pathological feature. However, not all fetuses demonstrate such an amplified “bandwidth”. If the fetus is exposed to a rapidly evolving hypoxia, simultaneous increased activity of the SNS to obtain more oxygen as well as enhanced activity of the PNS to reduce the myocardial workload can lead to autonomic instability. This exaggerated response can be seen on the CTG as a “ZigZag pattern” (ZZP) with variability >25 bpm lasting more than 30 s.

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