1 / 21

Fetal Monitoring Basics

Fetal Monitoring Basics. NUR 134 M. Johnston, RN-BC, M.Ed. Types of Monitoring. Auscultation- listen to fetal heart rate (FHR) Electronic Fetal Monitoring – use of instruments to record FHR and uterine contractions(U/Cs). Auscultation.

leanne
Download Presentation

Fetal Monitoring Basics

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Fetal Monitoring Basics NUR 134 M. Johnston, RN-BC, M.Ed.

  2. Types of Monitoring Auscultation- listen to fetal heart rate (FHR) Electronic Fetal Monitoring – use of instruments to record FHR and uterine contractions(U/Cs)

  3. Auscultation • Doppler - ultrasound converts sounds waves to signals of fetal heart • Fetoscope- Like stethoscope, open end pressed on abdomen, used less frequently

  4. Electronic Fetal Monitoring • Measures response of FHR to uterine contractions (U/Cs) • Intermittent or Continuous • External • Ultrasound transducer • Tocotransducer • Internal • Fetal Scalp Electrode • Intrauterine Pressure Catheter

  5. Fetal Monitoring Setup http://www.youtube.com/watch?v=DvcDXvlCXAE&feature=player_embedded

  6. Fetal Heart Rate Characteristics • Evaluate to determine fetal status • NICHD terminology • Baseline Rate • BaselineVariability • Accelerations (present or absent) • Decelerations (present or absent) • Changes or trends over time

  7. Baseline (BL) • Normal range 110-160 bpm • Measure between U/Cs for 10 min. period • Tachycardia - >160 bpm for >10 minutes • Bradycardia - <110 bpm for >10 minutes

  8. Classifications of FHR Variability • Fluctuations in FHR, irregular in frequency and amplitude • Absent 0-2 bpm • Minimal >2 <6 bpm • Moderate 6 -25 bpm • Marked >25 bpm

  9. Accelerations • Abrupt increase in FHR above BL • Present or Absent • < 32 wks gestation • Peak ≥ 10 bpm above BL for at least 10 sec. • >32 wks gestation • Peak ≥ 15 bpm above BL for at least 15 sec. • Accel ≥ 10 min. is defined as BL change

  10. Accelerations • Abrupt increase in FHR above BL • Peak ≥ 15 bpm above BL for at least 15 sec.

  11. Types of Decelerations • Early – Gradual decrease and return to BL,mirrors the U/C • Variable – Abrupt (<30 sec) decrease (≥15 sec down, lasting ≥ 15 sec and <2 min from onset to return to BL) • Late – Gradual decrease (≥30 sec) and gradual return to BL; delayed timing nadir occurs after peak of U/C • Prolonged – Decrease in FHR below BL ≥15 sec, lasting ≥ 2 min. but <10 min.

  12. Early Deceleration • Gradual decrease and return to BL • Mirrors the U/C

  13. Variable Deceleration • Abrupt (<30 sec) decrease (≥ 15 sec down, lasting ≥ 15 sec and < 2 min. from onset to return to BL)

  14. Late Deceleration • Gradual decrease (≥ 30 sec) and gradual return to BL • Delayed timing, nadir occurs after peak of U/C

  15. Prolonged Deceleration • Decrease in FHR below BL ≥ 15 sec, lasting ≥ 2 min. but < 10 min.

  16. Fetal Heart Rate Interpretation System Normal Indeterminate Abnormal

  17. FHR Interpretation • Information about fetal oxygenation/placental function • Somewhat subjective • Abnormal patterns may need further testing

  18. Monitoring Uterine Contractions • Assess U/C pattern while assessing FHTs • External • Palpation • EFM Toco measures frequency, duration • Noninvasive • Internal • Intrauterine pressure catheter (IUPC) • Measures exact intrauterine pressure • Invasive

  19. Why Monitor? • FHR changes in response to oxygenation, gestation, and certain stimuli • EFM provides more objective data than auscultation • Infers information about current and ongoing fetal oxygenation

  20. Interventions • Abnormal FHR pattern: • Change maternal position • Give oxygen via mask • Increase IV fluids • Consider medication to relax uterus

  21. Other Fetal Surveillance • Non-Stress Test (NST) - EFM • Contraction Stress Test (CST) - EFM • Biophysical Profile (BPP) - U/S • Doppler Flow Studies/Growth - U/S • Fetal Movement Count-maternal sensation/palpation

More Related