Electronic Fetal Monitoring Flashcards
What are examples of electronic fetal monitoring (EFM)
Continuous Fetal heart rate = indirect measure of fetal oxygenation of almost all births
- also determines fetal hypoxia/acidosis during labor
- reduces hypoxic-ischemic encephalopathy, CP and fetal death rates
- *must compare it to the uterine contractions**
- dark vertical lines =1 min apart
- light vertical lines = 10 seconds apart
Uterine activity in EFM
Contractions
- frequency (time from one contraction to the next (should be equal to or less than 5 contractions in 10 minutes)
- Duration of contractions (length of time of one contraction to the next in seconds)
- Intensity (mild, moderate or strong rating based on what you feeling during palpation)
- resting tone between contractions (rated soft or hard based on what is felt on palpation)
Baseline heart rate for FHR on EFM
Appreciate mean FHR rounded to increments of 5 bpm during a 10 minute window
- exclude accelerations or decelerations
Normal = 110-160 bpm
Bradycardia = <110
- anemia, dehydration, cardiac anomalies, hypoxia
Tachycardia = > 160
- hypotension, hyperthermia, hypoglycemia, cord compression, hypoxia
Special examples of baseline HR in FHR measurements with EFM
Absent = amplitude range is undetectable
- metabolic acidosis
- EMERGENT DELIVERY needed
Minimal amplitude
- causes = corticosteroid use, general anesthesia, hypoxia, magnesium sulfate use, prematurity
Marked amplitude (amplitude range > 25 bpm) - hypoxia and excessive stress
Sinusoidal amplitude (looks like constant sine waves for HR)
- severe fetal anemia/hypoxia (often is placental abruption)
- EMERGENT DELIVERY
Accelerations of EFM
Indicates adequate central fetal oxygenation, fetal movement, predict absence of fetal hypoxia and acidemia
> 32 weeks = at least 15 bpm above baseline is normal
(15 x15)
< 32 weeks = 10 bpm for 10 seconds is normal
(10 x 10)
Common interventions to abnormal EFM
Change maternal position to maximize uterine blood flow
Give oxygen 10 LPL in hypoxic
Give fluid bolus of 500 mL
always call for an OB team and NICU team to prepare for emergent delivery if needed
