Intrapartum fetal monitoring. 2009

R Eugene Bailey
SUNY Upstate Medical University, 475 Irving Ave., Syracuse, NY 13210, USA. baileye@upstate.edu

Continuous electronic fetal monitoring was developed in the 1960s to assist in the diagnosis of fetal hypoxia during labor. Continuous electronic fetal monitoring has been shown to reduce the incidence of neonatal seizures, but there has been no beneficial effect in decreasing cerebral palsy or neonatal Continuous electronic fetal monitoring was developed in the 1960s to assist in the diagnosis of fetal hypoxia during labor. Continuous electronic fetal monitoring has been shown to reduce the incidence of neonatal seizures, but there has been no beneficial effect in decreasing cerebral palsy or neonatal mortality. Intraobserver variability may play a major role in its interpretation. To provide a systematic approach to interpreting the electronic fetal monitor tracing, the National Institute of Child Health and Human Development convened a workshop in 2008 to revise the accepted definitions for electronic fetal monitor tracing. The key elements include assessment of baseline heart rate, presence or absence of variability, and interpretation of periodic changes. The workshop introduced a new classification scheme for decision making with regard to tracings. This system can be used in conjunction with the Advanced Life Support in Obstetrics course mnemonic, DR C BRAVADO, to assist in the systematic interpretation of fetal monitoring. DR C BRAVADO incorporates maternal and fetal risk factors (DR = determine risk), contractions (C), the fetal monitor strip (BRA = baseline rate, V = variability, A = accelerations, and D = decelerations), and interpretation (O = overall assessment).

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D001919 Bradycardia Cardiac arrhythmias that are characterized by excessively slow HEART RATE, usually below 50 beats per minute in human adults. They can be classified broadly into SINOATRIAL NODE dysfunction and ATRIOVENTRICULAR BLOCK. Bradyarrhythmia,Bradyarrhythmias,Bradycardias
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013610 Tachycardia Abnormally rapid heartbeat, usually with a HEART RATE above 100 beats per minute for adults. Tachycardia accompanied by disturbance in the cardiac depolarization (cardiac arrhythmia) is called tachyarrhythmia. Tachyarrhythmia,Tachyarrhythmias,Tachycardias
D015148 Cardiotocography Monitoring of FETAL HEART frequency before birth in order to assess impending prematurity in relation to the pattern or intensity of antepartum UTERINE CONTRACTION. CTG, Antepartum,Cardiotocogram,Electronic Fetal Monitoring,External Cardiotocography,External Fetal Monitoring,Internal Cardiotocography,Internal Fetal Monitoring,Antepartum CTG,Cardiotocograms,Cardiotocography, External,Cardiotocography, Internal,Fetal Monitoring, Electronic,Fetal Monitoring, External,Fetal Monitoring, Internal,Monitoring, Electronic Fetal,Monitoring, External Fetal,Monitoring, Internal Fetal

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