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EFM 2023/2024 already graded A+
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EFM 2023/2024 already graded A+
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EFMFetal monitor Paper speed
3cm/minute
Each small box equals
10 seconds
dark vertical lines equal
1 minute
Fetal heart rate is measured as
beats per minute (BPM)
Uterine activity is measured as
millimeters of mercury (mmHg)
Fetal heart rate monitors
external US Doppler
internal fetal spiral electrode (FSE)
Uterine activity contraction monitors
external TOCO (tochodynamometer
internal Intrauterine pressure catheter (IUPC)
External fetal monitor US Doppler
measures ultrasonic wave
detects FHR baseline, variability, accelerations, decelerations
noninvasive
affected by fetal/maternal movement, fetal position, maternal obesity
Montevideo units (MVU) are calculated
by subtracting the baseline uterine pressure from the peak contraction pressure for each
contraction in a 10-minute window and by adding the pressures generated by each contraction.
, Baseline Fetal HR
- Norm: 110-160
- Determined in a 10 min interval
- Look at FHR between UCs
- ALWAYS RECORD to CLOSEST 5 BEATS
[Ex: 120-130= FHR= 125]
Fetal Bradycardia
-less than 110 bpm
causes include
- Vag stimulation
- Maternal Drugs [Pain meds]
- Hypoxemia
- Fetal Conduction Defect
- Maternal pulse picked up by error
A FHR baseline less than 110 bpm for at least a 10 minute period
Fetal Tachycardia
- >160 bpm
- Maternal & Fetal Infections w/ fever
- Tocolytics
- Premie w/ immature Parasymp NS
- Fetal Cardiac Problems
- Maternal Dehydration w/ fever
- Hypoxemia
FHR Variability
The beat to beat changes that have an amplitude of:
- Absent: 0
- Minimal: <5
- Moderate: 6-25 bpm [norm]
- Marked: >25
Causes of decreased variability
- Sleep
- Maternal meds
- Immature fetus
- CNS Anomalies
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