After application of instruments, 90% of CTG traces showed abnormal features. Tachycardia, baro- and chemoreceptor-mediated decelerations, and saltatory patterns were the most common abnormalities. Increased baseline FHR during vacuum as compared to forceps delivery was possibly secondary to pain/pressure and resultant sympathetic overactivity. The saltatory pattern was more common in forceps deliveries, possibly secondary to increased intracranial pressure and resultant autonomic instability. Despite these CTG abnormalities, the perinatal outcomes were good.