Basic Fetal Heart Monitoring
Basic Fetal Monitoring - ANS-HR means fetus is okay, we monitor at least 2 patients
(mom and baby), continuous monitoring mom must stay in her room (not bed),
intermittent monitoring is done with a hand held doppler (checks mom's HR as well),
palpate radial pulse of mom, internal external or mixture depends on labor situation,
listen before, during, and after contractions!
Electronic Fetal Monitoring - ANS-continuous tracing of FHR, assess tolerance of labor,
under normal conditions there is a fetal reserve pf oxygen that ensures stress to fetus is
minimal, detects how fetus is responding to stress of uterine contractions, during each
contraction there is a temporary reduction in maternal blood flow to fetus through
placenta
Intermittent External Monitoring - ANS-fetal heart tones: hand held doppler, ultrasound,
stethoscope, fetoscope (used to be method of choice)
contractions: palpation at same time with doppler, mild contraction (nose), strong
(forehead), moderate (chin)
Continuous External Monitoring - ANS-fetal heart tones: ultrasound transducer
contractions: tocotransducer (only tells contraction is present not strength)
Internal Monitoring - ANS-continuous! water must be broken (we break with
amniometry)
fetal heart tones: fetal scalp electrode, corkscrews into fetal head, cable anchored to
maternal inner thigh and plugged into monitor, beat to beat breakdown
contractions: intrauterine pressure catheter, tells us contractions present AND how
strong they are, strength expressed with MVU between 180-220, catheter sits between
uterine wall and fetus
Fetal Heart Monitoring Strip - ANS-FHR on top, contractions on bottom
Fetal Heart Rate Baseline - ANS-normal fetal heart rate is 110-160 bpm @ term, over
160 is fetal tachycardia, assess over 10 minutes to determine baseline, round to nearest
5 bpm increments (always ends in 5 or 0), baseline change is an increase in the heart
rate for over 10 minutes, there must be at least 2 minutes of identifiable baseline in any
10 minute window or the baseline is indeterminate, may need to refer to previous 10
min window
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