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1. Fetal monitor Paper speed 3cm/minute
2. Each small box equals 10 seconds
3. dark vertical lines equal 1 minute
4. Fetal heart rate is measured as beats per minute (BPM)
5. Uterine activity is measured as millimeters of
mercury (mmHg)
6. Fetal heart rate monitors external US Doppler
internal fetal spiral
electrode (FSE)
7. Uterine activity contraction monitors external TOCO (tochody-
namometer
internal Intrauterine
pressure catheter (IUPC)
8. External fetal monitor US Doppler measures ultrasonic
wave detects FHR
baseline, vari-ability,
accelerations, decelera-
tions
noninvasive
attected by fetal/maternal
movement, fetal position,
ma-ternal obesity
9. Montevideo units (MVU) are calculated by subtracting the baseline
uterine pressure from the peak
contraction pressure for each
contraction in a 10-minute
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window and by adding
the pressures generated
by each contraction.
10. Baseline Fetal HR - Norm: 110-160
-Determined in a 10 min
inter-val
-Look at FHR between UCs
-ALWAYS RECORD to
CLOSEST 5 BEATS
[Ex: 120-130= FHR= 125]
11. Fetal Bradycardia -less than 110
bpm causes
include
-Vag stimulation
-Maternal Drugs [Pain meds]
-Hypoxemia
-Fetal Conduction Defect
-Maternal pulse picked
up by error
A FHR baseline less than
110 bpm for at least a 10
minute period
12. Fetal Tachycardia - >160 bpm
-Maternal & Fetal Infections
w/ fever
-Tocolytics
-Premie w/
immature
Parasymp NS
-Fetal Cardiac Problems
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-Maternal Dehydration w/
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fever
-Hypoxemia
13. FHR Variability The beat to beat changes
that have an amplitude
of:
-Absent: 0
-Minimal: <5
-Moderate: 6-25
bpm [norm]
-Marked: >25
14. Causes of decreased variability - Sleep
-Maternal meds
-Immature fetus
-CNS Anomalies
-Fetal HYPOXIA
15. Sinusoidal Pattern Saw tooth pattern
associated w/ severe ANEMIA or
severe HYPOXIA
16. FHR Category I "Normal" - Baseline FHR: 110-160
-Baseline Variability:
Moder-ate
-0 Late or Variable Decels
-0 +/- Early Decels
-0 +/- Accelerations
Well oxygenated, normal acid
base
17. FHR Category II "Intermediate" - Bradycardia
-Tachycardia
-Baseline Variability: Minimal