Fetal Monitoring Flashcards
What are the two types of fetal monitoring?
Intermittent Auscultation and Continuous Electronic Fetal Monitoring
What does EFM assessment evaluate?
Uterine contractions (UC), Baseline FHR, FHR variability, Accelerations, Decelerations, Trends of FHR patterns over time
What is considered a ‘normal’ uterine contraction rate?
< 5 contractions in 10 minutes (averaged over a 30-minute window)
What defines tachysystole in uterine contractions?
> 5 contractions in 10 minutes (averaged over a 30-minute window)
How is baseline FHR defined?
The approximate mean FHR rounded to increments of 5 bpm
What is the normal range for baseline FHR?
110-160 bpm
What is baseline tachycardia?
FHR >160 bpm for >10 minutes
What can cause baseline tachycardia?
Excessive fetal movement, maternal fever, dehydration, chorio, drugs, hypoxia
What is baseline bradycardia?
FHR <110 bpm for >10 minutes
What are common causes of baseline bradycardia?
Maternal hypothermia, complete fetal heart block, post-term pregnancy, magnesium sulfate
What is marked variability in FHR?
> 25 bpm
What is moderate variability in FHR?
6-25 bpm
What is minimal variability in FHR?
> Undetectable but <5 bpm
What is absent variability in FHR?
Undetectable
What characterizes a sinusoidal pattern in FHR?
Visually apparent, smooth, sine wave-like undulating pattern with a cycle frequency of 3-5/min that persists for > 20 minutes
What are accelerations in FHR?
Abrupt increase in the FHR 15 beats above the baseline lasting a minimum of 15 seconds
What causes early decelerations?
Head compression
What interventions are needed for early decelerations?
Not a concerning pattern, sterile vaginal exam, prepare for birth
What causes late decelerations?
Placental insufficiency
What are the characteristics of chronic late decelerations?
Repetitive, associated with minimal variability, subtle, not correctable
What are variable decelerations caused by?
Cord compression
What shape do variable decelerations typically have?
V, U or W shaped
What does the mnemonic VEAL CHOP stand for?
- V = variable decel
- E = Early decel
- A = accelerations
- L = Late decel
- C = Cord Compression
- H = head compression
- O = Okay!
- P = Placental perfusion
What defines prolonged decelerations?
Deceleration 2-10 minutes long
What are the three central concepts of intrapartum FHR interpretation?
- Periodic decelerations
- Episodic decelerations
- Recurrent decelerations
What characterizes Category I FHR patterns?
BL FHR 110-160 bpm, moderate FHR variability, no late or variable decelerations, present or absent early decelerations, present or absent accelerations
What defines Category II FHR patterns?
BL bradycardia without absent variability, BL tachycardia, minimal/marked variability, absent variability without recurrent decelerations
What indicates Category III FHR patterns?
Absent variability and any of the following: recurrent late decelerations, recurrent variable decelerations, bradycardia, sinusoidal pattern
