What are the two different kinds of EFM?
Uterine and Fetal
What are the two different kinds of Uterine (ultra sound) and what do they test for?
external (i.e., toco transducer-measures length and feq. of contraction) and internal, use intrauterine pressure catheter (IUPC) that measures length, frequency, and intensity of contraction.
What are the 3 different types of fetal (heart rate) EFM?
External: doppler, fetoscope "intermittent" that measures rate.
External: U/S transducer "continuous" measures rate and variability w/ contractions.
Internal: Spiral electrode that measures EKG with accurate variability.
When can you use an IUPC?
When the water is broke and measures in mmhg
When do you use intermittent vs. continuous EFM?
Intermittent when baby is healthy and continuous if high risk labor.
Where is the best place to listen to fetal heart rate?
On the back of the fetus.
What is normal fetal heart rate and what is variability?
Normal 110-160 (as baby matures the heart rate will slow). Variability is periodic changes in heart beat (want variability).
What do variable decelerations indicate?
What are 5 types of variability?
1. Absent- undectectable amplitude range
2. Minimal- detectable but less than 5 bpm
3. Moderate- "expected" 6 to 25 bpm
4. Marked- Greater than 25 bpm
5. Sinusoidal- CRAZINESS!!
What do accelerations indicate?
The baby is oxygenated and doing well.
What is considered fetal tachycardia? What causes? Tx?
Heart rate of >160 bpm for 10 minutes, caused from maternal fever or uterine hyper-stimulation, tx: shut off pitocin
What is fetal bradycardia?
Heart rate <110 bpm for 10 minutes.
What do early decelerations indicate? what do they look like on monitor?
Signals head compression and mirrors the contraction (starts and stops at the same time). Needs watching.
What do late decelerations indicate?
Means the placenta is not being perfused enough to oxygenate fetus. Worrisome
Can you have variable without a contraction?
What does it mean if you lose variability?
Labor is taking a toll on the baby.
what is the tx for variable decels?
1. Turn mom to opposite side to relieve cord compression. 2. Start fluids 3. 0xygenate