Basic Fetal Monitoring - Southwest PECSouthwest ：基本的胎儿监护西南PEC西南.ppt

Author: Kathleen Murray, CNM, RN, MN Basic Fetal Monitoring Southwest Washington Perinatal Education Consortium Objectives Identify the components of a fetal heart rate pattern: baseline, variability, accelerations, decelerations, periodic, and non-periodic changes Discuss maternal and fetal physiology and how it influences fetal heart rate patterns Differentiate criteria for reassuring and non-reassuring fetal heart rate patterns Fetal Heart Rate Monitoring Techniques Auscultation Fetoscope Auscultation Fetoscope Low tech Need quiet room Auscultation Doppler Motion detector Portable Some models are made for underwater use (in tub) Doppler Doppler used throughout pregnancy and labor Auscultation Benefits Detects baseline FHR rhythm and dysrhythmias Hear changes in fetal heart rate Differentiates maternal from fetal heart rate Auscultation Limitations Not continuous No printout or computer record Can’t demonstrate variability Requires some 1:1 nurse-time May be limited by position of mother Fetal Heart Rate Monitoring Techniques Electronic Fetal Monitoring External Internal Fetal Monitoring Strip What’s the Purpose of Fetal Monitoring??? Purpose of Electronic Fetal Monitoring Identify reassuring signs of fetal well-being Screen for non-reassuring signs of a fetus who is at risk Benefits of External Fetal Monitoring (EFM) Noninvasive Paper document Demonstrates variability Less labor intensive Limitations of EFM Restricts patient movement Measures cardiac motion, is not ECG Doubling or half-count of FHR possible Might pick up maternal HR instead Internal Fetal Monitoring Spiral electrode (FSE) provides direct ECG Measures interval between R waves Produces very accurate picture of FHR Benefits of Internal Monitoring (Using FSE) Accurate measure of FHR and variability May detect dysrhythmias Can allow for more patient movement Limitations of FSE Membranes