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6 - Fetal monitoring

Published online by Cambridge University Press:  21 August 2009

Alexander Heazell
Affiliation:
University of Manchester
John Clift
Affiliation:
City Hospital, Birmingham
Justine Nugent
Affiliation:
Clinical Research Fellow, Maternal and Fetal Health Research Centre, St Mary's Hospital and University of Manchester, Manchester, UK
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Summary

Electronic fetal monitoring (EFM) primary screening test is a highly sensitive test detecting a disease with a low prevalence. The fetal heart rate (FHR) trace or cardiotocograph (CTG) has five recognisable features: uterine activity, baseline FHR, baseline variability, accelerations and decelerations. The National Institute for Health and Clinical Excellence guidelines on EFM recommend that a CTG or FHR trace is classified into one of three groups: normal, suspicious or pathological based on the presence of reassuring and non-reassuring features. Fetal blood sampling (FBS) is used to identify compromised fetuses that need immediate delivery from those that are fine. There is a need for a monitoring system with a high specificity and sensitivity for detecting fetal acidosis and allowing timely and appropriate intervention without putting the fetus at risk. Currently, systems being researched include fetal ECG analysis and fetal oxygen saturation monitoring.
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Chapter
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Publisher: Cambridge University Press
Print publication year: 2008

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References

Nelson, K. B., What proportion of cerebral palsy is related to birth asphyxia?J. Pediatr., 112:4 (1988), 572–4.Google Scholar
Vintzileos, A. M., Nochimson, D. J., Guzman, E. R.et al., Intrapartum electronic fetal heart rate monitoring versus intermittent auscultation: a meta-analysis. Obstet. Gynecol., 85:1 (1995), 149–55.Google Scholar
Thacker, S. and Stroup, D., Continuous electronic heart rate monitoring versus intermittent auscultation for assessment during labour. Cochrane Database Syst. Rev., 1999. Issue no. 3.Google Scholar
Modanlou, H. D. and Murata, Y., Sinusoidal heart rate pattern: reappraisal of its definition and clinical significance. J. Obstet. Gynaecol. Res., 30:3 (2004), 169–80.Google Scholar
Clinical Effectiveness Support Unit of the Royal College of Obstetricians and Gynaecologists. The Use and Interpretation of Cardiotocography in Intrapartum Fetal Surveillance – Evidence-based Clinical Guideline 8. (London: Royal College of Obstetricians and Gynaecologists Press, 2001).
ACOG technical bulletin, Fetal heart rate patterns: monitoring, interpretation, and management. Number 207 – July 1995 (replaces No. 132, September 1989). Int. J. Gynaecol. Obstet., 51:1 (1995), 65–74.
Elimian, A., Figueroa, R. and Tejani, N., Intrapartum assessment of fetal well-being: a comparison of scalp stimulation with scalp blood pH sampling. Obstet. Gynecol., 89: 3 (1997), 373–6.Google Scholar
Lazebnik, N., Neuman, M. R., Lysikiewicz, A., Dierker, L. R. and Mann, L. I., Response of fetal heart rate to scalp stimulation related to fetal acid–base status. Am. J. Perinatol., 9:4 (1992), 228–32.Google Scholar
Spencer, J. A., Predictive value of a fetal heart rate acceleration at the time of fetal blood sampling in labour. J. Perinat. Med., 19:3 (1991), 207–15.Google Scholar
Mistry, R. and Neilson, J., Fetal electrocardiogram plus heart rate recording for fetal monitoring during labour. Cochrane Database Syst. Rev., 2 (1999), CD000116.Google Scholar
Strachan, B. K., Wijngaarden, W. J., Sahota, D., Chong, A. and James, D. K., Cardiotocography only versus cardiotocography plus per rectum-interval analysis in intrapartum surveillance: a randomised, multicentre trial. FECG Study Group. Lancet, 355:9202 (2000), 456–9.Google Scholar
Maclachlan, N. A., Spencer, J. A., Harding, K. and Arulkumaran, S., Fetal acidaemia, the cardiotocograph and the T/QRS ratio of the fetal Electrocardiograph in labour. Br. J. Obstet. Gynaecol., 99:1 (1992), 26–31.Google Scholar
Dildy, G. A., Thorp, J. A., Yeast, J. D. and Clark, S. L., The relationship between oxygen saturation and pH in umbilical blood: implications for intrapartum fetal oxygen saturation monitoring. Am. J. Obstet. Gynecol., 175:3 Pt 1 (1996), 682–7.Google Scholar
Confidential Enquiry into Stillbirths and Deaths in Infancy. Seventh Annual Report. 1st January to 31st December 1998. (London: Maternal and Child Health Consortium, 2000).
Gauge, S. M. and Henderson, C.Cardiotocograph Made Easy 3rd edn (Edinburgh: Churchill Livingstone, 2005).
James, D. K.Steer, P. J., Weiner, C. P. and Gonis, B., High Risk Pregnancy: Management Options, 3rd Edn (Edinburgh: Saunders, 2006).
Kean, L. H.Baker, P. N. and Edelstone, D. I., Best Practice in Labour Ward Management (Philadelphia: Saunders, 2000).
Mitchell, T., Cardiotocographs: Guidance for Interpretation: the Crimson File: a Selection of Cases Compiled During a Confidential Enquiry (Solihull: West Midlands Perinatal Audit, 1995).

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  • Fetal monitoring
    • By Justine Nugent, Clinical Research Fellow, Maternal and Fetal Health Research Centre, St Mary's Hospital and University of Manchester, Manchester, UK
  • Alexander Heazell, University of Manchester, John Clift
  • Book: Obstetrics for Anaesthetists
  • Online publication: 21 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544569.008
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Fetal monitoring
    • By Justine Nugent, Clinical Research Fellow, Maternal and Fetal Health Research Centre, St Mary's Hospital and University of Manchester, Manchester, UK
  • Alexander Heazell, University of Manchester, John Clift
  • Book: Obstetrics for Anaesthetists
  • Online publication: 21 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544569.008
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Fetal monitoring
    • By Justine Nugent, Clinical Research Fellow, Maternal and Fetal Health Research Centre, St Mary's Hospital and University of Manchester, Manchester, UK
  • Alexander Heazell, University of Manchester, John Clift
  • Book: Obstetrics for Anaesthetists
  • Online publication: 21 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544569.008
Available formats
×