Fetal monitoring

Toca

measures contractions, put on the fundus

Parameters for assessment of contractions

• frequency

• duration

• interval

• intensity

• resting tone

What does fetal monitoring assess

duration

frequency

resting tone

Baseline HR

average, where heart rate sits for the longest period of time

What makes fetal monitor strip reactive

• monitor 20-30 minutes

• baby needs 2-3 accelerations that last 15 seconds, 15 beats above baseline

Variability

• FHR is under constant variation from baseline

• reflects a healthy nervous system and cardiac responsiveness

• Will not see until 32-34 weeks

Variable decelerations

Cord compression

Early decelerations

head compression

Accelerations

Okay- good baby is active

Late decelerations

placental insufficiency BAD

placenta is not doing its job

Early decelerations

Starts before peak of contraction

means fetal head compression

Means that head is low into pelvis (ready for delivery)

*check cervix

Variable decelerations

Baby is going hypoxic

Cord compression, V shape, deceleration occurs during contraction

Care:

• Change mom’s position

• oxygen

• IV fluids

• Shut off pitocin if on

• Call dr

Late declerations

HR drops after contraction

Placental insufficiency, not delivering oxygen to baby

placenta is not flowing enough blood through to baby

prepare for c-section

Fetal tachycardia

>160

causes:

• maternal fever

• fetal hypoxia

• maternal infection

• Drugs: terbutaline, atropine

When you see fetal tachycardia what is first thing you should do

take mom’s temp

Fetal bradycardia

<100

causes:

• cord compression

• cord prolapse

• tetanic uterine contractions (contractions w/o a break)

• epidural and spinal anesthesia

• Rapid descent: vagal response

• Vigorious vaginal exam: vagal response