Fetal Heart Monitoring
Purpose of Fetal Monitoring - ANS-Assist the clinician to identify Fetal Distress and
Intervene in a timely manner and decrease the incidence of neurological impairment
Right treatment of fetal asphyxia
Frequency of FHR Monitoring - ANS-Low Risk High Risk
Latent q1hr q30min
Active q30 q 15 min
Second q 15min q 5 min
Fetoscope and Doppler - ANS-Used to detect FHR convenient and rapid
Cannot Determine variability, detect small changes(contractions)
Does not provide a continuous record
External Ultrasound Transducer - ANS-Measures the movement of the fetal
myocardium
Provides continuous FHR readings and visual assesm
Detects periodic changes in FHR
Fast non invasive way to obtain
Lepold's Maneuver - ANS-Palpating abdomen for fetal position
Locate fundus, Palpate Down each side, Palpate at symphisis pubis, Palpate need to
know neck
Internal Fetal Scalp Electrode - ANS-Attaches to presenting part, Measure fetal EKG
and records measurement between R waves to give FHR
Provides a continuous tracing
Shows periodic and non periodic changes. Variability is more accurate
Indications for IFSE use - ANS-Use this when hard to monitor externally due to
movement, want to measure, high risk pregnancy.
Must have ROM and dilated cervix, contraindicated with infection, can damage
presenting part. Must detach before c section.
Ways to monitor UC - ANS-palpation, tocotransducer, intrauterine pressure catheter
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