what is the goal of fetal monitoring - ANSinterpretation and ongoing assessment of fetal
oxygenation
what is EFM - ANStechnique used for fetal assessment based on the face that the FHR reflects
fetal oxygenation
baseline FHR - ANSmean fetal heart rate of 5bpm during a ten min window
baseline variability - ANSfluctuations in the baseline FHR that are irregular in amplitude and
frequency
absent - amplitude range is undetectable
minimal - amplitude range is visually undetectable <5
moderate - amplitude from peak to trough 6 bpm to 25
marked - amplitude range >25
accelerations - ANSvisually apparent, abrupt increase in FHR above the baseline
prolonged acceleration - ANS>2 mins but <10 mins, acceleration lasting between 2 and 10 mins
deceleration - ANStransitory decrease in the FHR from the baseline
early deceleration - ANSgradual decrease in FHR below the baseline, nadir (lowest point) of the
deceleartion occurs at the same time as the peak of the UC, this is okay to happen
variable decleration - ANSabrupt decrease, >15 bpm lasting >15 seconds in a <2 min duration,
more than 15 beats below the baseline
late decleration - ANSgradual decrease, nadir occurs after the peak, deceleration happens after
the peak of he acceleration, bigger issue
prolonged deceleartion - ANSabrupt decrase >15bpm lasting >2 minutes but <10, more than 15
bpm below the baseline lasting for 2-10mins
sinusoidal pattern - ANSsmooth sine like wave like undulating pattern in FHR baseline with a
cycle frequency of 3-5 min that persists for >20 mins
auscultation - ANSuse of a fetoscope of doppler to hear FHR by exterally listening without the
use of a paper recorder
fetoscope - ANShear opening and closing of the ventricular valve
, doppler - ANSuses ultrasound using sound waves deflected from feta heart movement
What does auscultation assess - ANSFHR, baseline, rhythm, changes from baseline
palpation of contractions - ANSuterus contracts the musclature becomes firm and tense,
measures the frequency, duration and tone and intensity
how do you palpate contractions - ANSplacing the fingertips on the fondus and assessing the
degree of tension as the contractions occurs
when and what scale is the intensity of the contraction measured on - ANSmeasured at the
peak of the contraction
mild or 1+ - feels like the tip of the nose, easily indented
moderate or 2+ feels like the chin (can slightly indent)
strong or 3+ feels like the forehead (cannot indent uterus)
based on firmness
when and how is the resting tone meaured - ANSbetween contractions listed as either soft or
firm
external electronic fetal and uterine monitoring - ANSuses an ultrasound device to detect FHR
and a pressure device to assess uterine activity
what does the external EFM detect - ANSFHR baseline, variability, accelerations, and
decelerations
tocodynamometer - ANScontractions are measured by this, external uterine monitor, measures
the frequency duration of contractions and relative resting tone
what can external uterine monitors not measure - ANSpressure/intensity of the uterine
contractinos
internal electronic fetal and uterine monitoring - ANSfetal scalop electrode that is applied to the
presenting part of the fetus to directly detect FHR, involves a intrauterine pressure catheter
placed in the uterine cavity to directly measure uterine contraction
what do IUPC;s meacure and detect - ANSfrequency and duration , intensity and resting tone,
detects - FHR baseline, variability, acceleration, deelerations
IUPC - ANSintrauterine pressure catheter, objective measure of the pressure of contractions
expressed as mmHg
peak pressure - ANSmaximum uterine pressure during a contraction measured with an ICUP
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