Fetal Monitor Strips Examples
Absent variability
What is the variability?
Minimal variability
What is the variability?
Moderate variability
What is the variability?
Marked variability
What is the variability?
Absent variability: amplitude range undetectable
Causes: fetal hypoxemia, metabolic acidemia, congenital anomalies,
preexisting neurologic injury?
Monitor presents with this rhythm.
What is the variability?
What are the possible causes of this?
,Minimal variability: amplitude range detectable less than or equal to 5 bpm
Causes: fetal hypoxemia, metabolic acidemia, congenital anomalies,
preexisting neurologic injury, CNS depressant meds (analgesics, narcotics,
barbiturates, pentobarbital, tranquilizers, phenothiazines, general anesthesia),
can occur with tachycardia and prematurity or when fetus is temporarily in a
sleep state
Monitor presents with this rhythm.
What is the variability?
What are the possible causes of this?
Moderate variability: amplitude range 6-25 bpm
Clinical significance: Considered normal, Its presence is highly predictive of a
normal fetal acid-base balance (absence of fetal metabolic acidemia).
Indicates that FHR regulation is not significantly affected by fetal sleep cycles,
tachycardia, prematurity, congenital anomalies, preexisting neurologic injury,
or CNS depressant medications.
Monitor presents with this rhythm.
What is the variability?
What is the clinical significance?
Marked variability: amplitude range greater than or equal to 25 bpm
Monitor presents with this rhythm.
What is the variability?
,Sinusoidal FHR pattern: smooth, sine wavelike undulating pattern, cycling 3-5
min at a time and persisting for at least 20 min
Causes: chorioamnionitis, fetal sepsis, admin of narcotic analgesics
Monitor presents with this rhythm.
What is the rhythm?
What are the possible causes of this?
Fetal tachycardia: FHR >160 bpm lasting >10 min
Causes: early fetal hypoxemia, fetal cardiac arrhythmias, maternal fever,
infection (including chorioamnioitis), parasympatholytic drugs (atropine,
hydroxyzine), beta-sympathomimetic drugs (terbutaline), maternal
hyperthyroidism, fetal anemia, drugs (caffeine, cocaine, methamphetamines,
tocolytics)
Clinical significance: Persistent tachycardia in absence of periodic changes
does not appear serious in terms of neonatal outcome (especially true if
tachycardia is associated with maternal fever); tachycardia is abnormal when
associated with late decelerations, severe variable decelerations, or absent
variability.
Interventions: Dependent on cause; reduce maternal fever with antipyretics as
ordered and cooling measures; oxygen at 10 L/minute by nonrebreather face
mask may be of some value; carry out health care provider's orders based on
alleviating cause
Monitor presents with this rhythm.
What is the rhythm?
, What are the possible causes of this?
What is the clinical significance?
What are the nursing interventions?
Fetal bradycardia: FHR <110 bpm lasting >10 min
Causes: atrioventricular dissociation (heart block), structural defects, viral
infections (cytomegalovirus), medications, fetal HF, maternal hypoglycemia,
maternal hypothermia, placental transfer of drugs, prolonged compression of
umbilical cord, maternal hypotension
Clinical significance: Baseline bradycardia alone is not specifically related to
fetal oxygenation. The clinical significance of bradycardia depends on the
underlying cause and the accompanying FHR patterns, including variability,
accelerations, or decelerations.
Interventions: Dependent on cause
Monitor presents with this rhythm.
What is the rhythm?
What are the possible causes of this?
What is the clinical significance?
What are the nursing interventions?
Accelerations of FHR in a term pregnancy: a visually apparent abrupt increase
in FHR above the baeseline rate
