Basic Electronic Fetal Heart Monitoring
What does fetal monitoring tell us? - ANS-- Fetal oxygenation
- Acid-base status of the fetus
- Ability of the CNS to regulate FHR
- Why monitor? Prevention of hypoxia/asphyxia
Consequences of Inutero Hypoxia/Asphyxia - ANS-- Cerebral Palsy
- Mental retardation
- Epilepsy
- RDS (Respiratory Distress Syndrome)
- Renal damage
- NEC (Necrotizing Enterocolitis) = lack of O2 to gut --> permanent damage or necrosis
- Chronic brain impairment (permanent brain damage) = lack of O2 during birthing
process
Internal Fetal Monitoring - ANS-- IUPC (an internal contraction monitor) = introduced
through cervix and floats beside the baby
- FSE (an internal fetal heart monitor) = attached to baby's skin on head
- Used when fetus or mom keeps moving/repositioning
*Conditions: BOW must have ruptured and cervix must be dilated at least 3 cm
Remember... - ANS-- The intensity of contractions can only be measured objectively
with an IUPC in place
- Without it, the nurse must assess the strength of the contraction subjectively by
palpating the fundus during a contraction
- If the fundus tone feels like:
-- Tip of the nose = mild contraction
-- Chin = moderate contraction
-- Forehead = strong contraction
Counting Contractions - ANS-- Duration: From the beginning to the end of one
contraction (length of contraction)
- Frequency: Beginning of one contraction to the beginning of the next contraction
Uterine Perfusion During Contractions - ANS-Change in uterine blood flow with
contractions
Three Important Components of the Fetal Heart Monitor Strip - ANS-Baseline Heart
Rate
- Is it normal, bradycardia, tachycardia?
Variability
- Is it present or absent?
Periodic Changes
- Accelerations (increases in fetal HR)
- Decelerations: (decreases in fetal HR)
1. Early Decels (Benign)
2. Late Decels (Ominous)
3. Variable Decels (Ominous)
Basic Pattern Recognition - ANS-- Baseline FHR: 110-160 for 10 min.
- Tachycardia: FHR >160 for >10 min.
-- Most common cause is maternal infection
- Bradycardia: FHR <110 for > 10 min.
Variability - ANS-- The "squiggliness" of the FHR tracing
- Baseline variability is a measure of the interplay (the push-pull effect) between the
sympathetic and parasympathetic nervous systems
- Lack of variability is ominous
- Variability is the best indicator of fetal well-being
Periodic Changes: Accelerations - ANS-Transient increases above the FHR baseline
- Fetal movement
- Contractions
- Accelerations are positive/reassuring
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Hkane. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
