ch. 9 notes

  1. normal fetal HR
    110-160 beats/min
  2. palpation of contractions
    • frequency, duration, tone, intensity
    • -mild (1+), moderate (2+), strong (3+)
  3. 3 methods of monitoring HR
    • -manually (doptone, fetoscope)
    • -externally (ultrasound toco)
    • -internally (fetal electrode)
  4. electronic monitoring
    external: flexible disc on mothers abdomen, recorded on graph paper

    -when used with tocodynamometer, provides info from FHR in relation to the duration and frequency of contractions

    • internal: need to be dilated and have water broken
    • -cervix must be dilated at lease 2 cm
    • -wires extend from vagina to leg plate and connected to monitor
    • -stays on until delivery
  5. AWHONN Standards for frequency for FHR assessment
    • tells how often we need to chart, ever 1 hr.
    • active phase: every 15-30 mins
    • latent phase: 5-15 mins
  6. nichd & 3 tier fhr interpretation system
  7. intrapartum fetal monitoring
    • accelerations: 15x15 for 32 weeks and above, 10x10 under 32 weeks
    • -may be due to fetal activity or mild cord compression
    • -indicate adequate fetal oxygenation
  8. early decelerations
    may be due to head compression, mirror contractions, usually does not require intervention
  9. variable decelerations
    -due to cord compression, variable in shape and timing,  (v,w,u), change maternal position, iv bolus, o2, amnioinfusion
  10. late decelerations
    • (worst kind)
    • -caused by placental insufficiency
    • -late in onset, rounded shape
    • -change maternal position, iv bolus, o2, d/c pitocin
  11. intrauterine resuscitation
    interventions for nonreassuring FHR patterns are referred to as intrauterine resuscitation. these interventions maximize intravascular volume, uterine perfusion, placental exchange, and oxygen delivery to the fetus
Card Set
ch. 9 notes