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CTG interpretation
White / amber / red features and overall category.
Source: NICE NG229 (updated 2025)Baseline
| White | 110–160 bpm |
|---|---|
| Amber | 100–109, or rise ≥20 bpm, or can’t determine |
| Red | <100 or >160 bpm |
Variability
| White | 5–25 bpm |
|---|---|
| Amber | <5 for 30–50 min, or >25 for up to 10 min |
| Red | <5 for >50 min, >25 for >10 min, or sinusoidal |
Decelerations
| White | None, early, or variable without concerning features |
|---|---|
| Amber | Repetitive variable with concerning features <30 min |
| Red | Repetitive concerning variable >30 min; ANY late deceleration; prolonged ≥3 min |
Contractions
| White | <5 in 10 min |
|---|---|
| Amber | ≥5 in 10 min or hypertonus ≥2 min |
Overall
| Normal | All white — continue, hourly review. |
|---|---|
| Suspicious | 1 amber — conservative measures, consider review. |
| Pathological | 1 red or ≥2 amber — urgent obstetric review, consider expediting birth. |
| Urgent | Acute bradycardia / prolonged decel ≥3 min — expedite if not recovered by 9 min. |
Conservative measures
- Change position, avoid lying flat
- Reduce or stop oxytocin; terbutaline 250 mcg SC if contractions excessive
- IV fluids only if hypotensive or septic
- No facial oxygen for fetal reasons
Concerning variable decelerations: >60 s, reduced variability within, slow return to baseline, loss of shouldering. Accelerations (≥15 bpm for ≥15 s) are reassuring but not scored.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.