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Challenge yourself every tracing collection is FREE! Needs immediate intervention; may be due to severe fetal anemia, abdominal trauma or serious fetal infection. Minimal. Abrupt decrease, > 15 bpm, Sarah BSN, RN explains in this video tutorial some clever ways on how to learn these type of fetal heart rate decelerations. Fetal heart tracing allows your doctor to measure the rate and rhythm of your little one's heartbeat. fluid to the laboratory to screen the client for chlamydia b. send a sample of amniotic fluid to the laboratory to test for an elevated Rh-negative titer c. administer immune . FHR tracing, nonstress test, and ultrasound Teen pregnancy and consent issues: mother has consent over anything related to her pregnancy but anything apart . Practice basic fetal tracing analysis with some quizzes: Quizzes 1-5 Quizzes 6-10 Combine your ability to read fetal tracings with clinical management with some cases: Cases 1-5 If you want to see how you are doing overall, try the comprehensive assessment: Health care professionals play the game to hone and test their EFM knowledge and skills. Exerc Sport Sci Rev. What interventions would you take after evaluating this strip? When continuous EFM tracing is indeterminate, fetal scalp pH sampling or fetal stimulation may be used to assess for the possible presence of fetal acidemia.5 Fetal scalp pH testing is no longer commonly performed in the United States and has been replaced with fetal stimulation or immediate delivery (by operative vaginal delivery or cesarean delivery). Fetal bradycardia is a fetal heart rate of less than that 110 bpm, which is sustained for greater than or equal to 10 minutes. -medicated through vagus nerve w sudden release of ACh at fetal SA node, resulting in characteristic sharp decel A turfgrass stem that grows horizontally aboveground, c. A cool-season turfgrass that is very drought tolerant, e. A cool-season turfgrass used on putting greens, f. A turfgrass stem that grows horizontally below ground, g. A buildup of organic matter on the soil around turfgrass plants, i. The recommendations for the overall management of FHR tracings by NICHD, the International Federation of Gynecology and Obstetrics, and ACOG agree that interpretation is reproducible at the extreme ends of the fetal monitor strip spectrum.10 For example, the presence of a normal baseline rate with FHR accelerations or moderate variability predicts the absence of fetal acidemia.10,11 Bradycardia, absence of variability and accelerations, and presence of recurrent late or variable decelerations may predict current or impending fetal asphyxia.10,11 However, more than 50 percent of fetal strips fall between these two extremes, in which overall recommendations cannot be made reliably.10 In the 2008 revision of the NICHD tracing definitions, a three-category system was adopted: normal (category I), indeterminate (category II), and abnormal (category III).11 Category III tracings need intervention to resolve the abnormal tracing or to move toward expeditious delivery.11 In the ALSO course, using the DR C BRAVADO approach, the FHR tracing may be classified using the stoplight algorithm (Figure 19), which corresponds to the NICHD categories.9,11 Interventions are determined by placing the FHR tracing in the context of the specific clinical situation and corresponding NICHD category, fetal reserve, and imminence of delivery (Table 4).9,11, If the FHR tracing is normal, structured intermittent auscultation or continuous EFM techniques can be employed in a low-risk patient, although reconsideration may be necessary as labor progresses.2 If the FHR tracing is abnormal, interventions such as position changes, maternal oxygenation, and intravenous fluid administration may be used. Overview of Tachycardias and Fast Heart Rhythms. Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever) Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. CVS: 8-12 weeks, checks genetic/biochemical abnormalities, and short waiting time. Dont hesitate to reach out to us for anything as you progress through your career. Quiz, Chapter 24: Adolescent Sexual Activity and Teenage Pregnancy. The fetal heart rate tracing shows ALL of the following: Baseline FHR 110-160 BPM, moderate FHR variability, accelerations may be present or absent, no late or variable decelerations, may have early decelerations. Category II : Indeterminate. Sometimes, you may not be as far along as you thought and its just too early to hear the heartbeat. When the healthcare team detects a possible problem, their first step will be to try to find the cause. coincides with the peak of -pressure on fetal head Specific FHR tracings are analyzed in a stepwise manner. Match the term with the following definitions. Additionally, you may have difficulty detecting the heart rate even when the baby is perfectly fine. Contractions cause an increase in uterine venous pressure and a decrease in uterine artery perfusion. Prolonged decelerations (Online Figures K and L) last longer than two minutes, but less than 10 minutes.11 They may be caused by a number of factors, including head compression (rapid fetal descent), cord compression, or uteroplacental insufficiency. The different catagories of FHR tracings and their clinical meanings are discussed. Its carbon-14 (614C)\left({ }_{6}^{14} \mathrm{C}\right)(614C) activity is measured to be 60.0% of that in a fresh sample of wood from the same region. During a term antepartum NST (non-stress test), you notice several variable decelerations that decrease at least 15 bpm and last at least 15 secs long. . As a result of the intrinsic fetal response to oxygen deprivation, increased catecholamine levels cause the peripheral blood flow to decrease while the blood flows to vital organs increases. Preterm contractions are usually painful. The Fetal Heart Rate Tracing SecondLookTM app consists of three slide sets, which cover the basic interpretation of FHR tracings including the determination of baseline and variability, various types of acceleration and decelerations, and some examples and practice cases. -prolonged decel >2 min but <10 min What to Know About Epilepsy and Pregnancy. Most common association w fetal bradycardia? Enter your email address below and hit "Submit" to receive free email updates and nursing tips. The onset, nadir, and recovery of the deceleration usually coincide with the beginning, peak, and ending of the contraction, respectively.11 Early decelerations are nearly always benign and probably indicate head compression, which is a normal part of labor.15, Variable decelerations (Online Figure I), as the name implies, vary in terms of shape, depth, and timing in relationship to uterine contractions, but they are visually apparent, abrupt decreases in FHR.11 The decrease in FHR is at least 15 bpm and has a duration of at least 15 seconds to less than two minutes.11 Characteristics of variable decelerations include rapid descent and recovery, good baseline variability, and accelerations at the onset and at the end of the contraction (i.e., shoulders).11 When they are associated with uterine contractions, their onset, depth, and duration commonly vary with successive uterine contractions.11 Overall, variable decelerations are usually benign, and their physiologic basis is usually related to cord compression, with subsequent changes in peripheral vascular resistance or oxygenation.15 They occur especially in the second stage of labor, when cord compression is most common.15 Atypical variable decelerations may indicate fetal hypoxemia, with characteristic features that include late onset (in relation to contractions), loss of shoulders, and slow recovery.15. can you recognize these strip elements? abrupt: onset to nadir <30 sec, *uterine contractions/fetal head compression* ____ Prolonged D.)Gradual decrease; nadir Scalp. 2. Please try reloading page. With the help of this fetal heart monitoring trivia quiz and the questions accompanying it, you will know all about the process of fetal heart monitoring which exists to let you and your doctor see exactly how fast your unborn baby's heart is beating. Test your EFM skills using NCC's FREE tracing game! Intrapartum fetal heart rate monitoring. -*considered significantly non-reassuring, esp when repetitive and associated w decreased variability*, Repetitive late decelerations are defined as, occurring *after 50%+ of contractions in a 20 min* period, *uteroplacental insufficiency*, as a result of eitehr decreased uterine perfusion or decreased placental function Examples of Category II FHR tracings include any of the following: Strongly predictive of normal fetal acidbase status. May 2, 2022 The NCC EFM Tracing Game is part of the free online EFM toolkit at NCC-EFM.org. -*occur in presence of normal FHR variability* It is common to have a baseline heart rate of between 100-120 bpm in the following situations: Postdate gestation Occiput posterior or transverse presentations Severe prolonged bradycardia (less than 80 bpm for more than 3 minutes) indicates severe hypoxia. However, prolonged anxiety, stress, and high blood pressure could negatively affect your babys health. This content is owned by the AAFP. University of Rochester Medical Center. Perform a vaginal examination (check for cord prolapse, rapid descent of the head, or vaginal bleeding suggestive of placental abruption), 6. Dr. Hammoud has dedicated her career to medical student education and serves in many educational leadership roles locally and nationally. Theyll wrap a pair of belts around your belly. They really aren't intended for home monitoring. 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. Decrease in FHR is 15 bpm or greater, lasting 15 seconds, and < 2 minutes in duration. Join the nursing revolution. Periodic changes in FHR, as they relate to uterine contractions, are decelerations that are classified as recurrent if they occur with 50 percent or more of contractions in a 20-minute period, and intermittent if they occur with less than 50 percent of contractions.11 The decrease in FHR is calculated from the onset to the nadir of the deceleration. contraction Must be for a minimum of 2 minutes in any 10-minute segment. Category III tracings are associated with fetal acidemia, cerebral palsy and encephalopathy and require expedient intervention If intrauterine resuscitation (eg. For additional quantities, please contact [emailprotected] The baseline when the woman's abdomen is relaxed will be from zero to 10. Internally monitoring involves a thin wire and electrode placed through the cervix and attached to the baby's scalp. that there is no text inside the tags. Relevant ACOG Resources. Obstet Med. Incorrect. The use of amnioinfusion for recurrent deep variable decelerations demonstrated reductions in decelerations and cesarean delivery overall. It is important to review the pressure tracing before assessing the fetal tracing to accurately interpret decelerations. Decrease in FHR from the baseline that is 15 bpm or more, lasting 2 minutes or more but less than 10 minutes in duration. https://www.ncbi.nlm.nih.gov/pubmed/19546798 This web game uses NICHD terminology to identify tracing elements and categorize EFM tracings. They do a great job of both teaching and quizzing you on the relevant material. A change in baseline FHR is said to occur when the change persists for 10 minutes or longer. Additionally, an Apgar score of less than 7 at five minutes, low cord arterial pH (less than 7.20), and neonatal and maternal hospital stays greater than three days were reduced.22, Tocolytic agents such as terbutaline (formerly Brethine) may be used to transiently stop contractions, with the understanding that administration of these agents improved FHR tracings compared with untreated control groups, but there were no improvements in neonatal outcomes.23 A recent study showed a significant effect of maternal oxygen on increasing fetal oxygen in abnormal FHR patterns.24. Q: What is the most common obstetric procedure in the United States? Fetal heart rate (FHR) monitoring is the most widely used tool in clinics to assess fetal health. Electronic fetal monitoring may help detect changes in normal FHR patterns during labor. We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. Here's generally what to expect: Weeks 10 to 12 of pregnancy are very exciting for expectant parents. Your healthcare provider may do fetal heart monitoring during late pregnancy and labor. While it is not always a cause for concern, fetal heart rates outside the normal range may also indicate fetal distress. House Bill 645 would make it a misdemeanor punishable with a $500 fine to donate or accept blood . Palpate for uterine contraction during period of FHR auscultation to determine relationship, 5. Fetal bradycardia is defined as a baseline heart rate of less than 110 bpm. Category I FHR tracings include all of the following: Category II FHR tracings include all FHR tracings not categorized as Category I or Category III. Internal FHR monitoring is accom-plished with a fetal electrode, which is a spiral wire placed directly on the fetal scalp or other presenting part. What is the primary goal of effective communication in the care of the intrapartum patient? third stage: delivery of placenta, gradual: onset to nadir in 30 secs+ -physiologic, -onset, nadir, recovery occur after the contraction Nearly 100 years later, they found that very low heart rate (bradycardia) indicated fetal distress. What are the two most important characteristics of the FHR? Obstet Gynecol 1987; 70:191. Compared with EFM alone, the addition of fetal electrocardiography analysis results in a reduction in operative vaginal deliveries (NNT = 50) and fetal scalp sampling (NNT = 33). ____ Late A.) Ectopic Pregnancy Quiz Questions And Answers. The workshop introduced a new classification scheme for decision making with regard to tracings. -*associated w decreased or absent FHR variability*, 110-160 bpm Electronic fetal monitoring is performed in a hospital or doctors office. This is associated with certain maternal and fetal conditions, such as chorioamnionitis, fever, dehydration, and tachyarrhythmias. What qualifies as a rapid fetal heart rate? Fetal heart rate monitoring measures the heart rate and rhythm of your baby (fetus). The Fetal Heart Rate Tracing SecondLookTM application is a study aid for learners of the medical professions (specifically Ob/Gyn, nursing and midwifery) to self-test their level of knowledge about this important diagnostic procedure widely used in pre-natal care. -amnioinfusion can treat it in cases of oligohydramnios or when ROM has occurred to decrease rate of decels and C-sections, Recurrent decel (variable, early, late) defined as, decels occuring w >50% of uterine contractions in any 20 min segment, decrease in FHR >15 bpm measured from most recently determined baseline rate, *lasting >2 min, but <10 min* Well be concluding our series with a review of Fetal Heart Tracings. If you have any feedback on our "Countdown to Intern Year" series, please reach out to Samhita Nelamangala at d4medstudrep@gmail.com. Subtle, shallow late decelerations can be difficult to visualize, but can be detected by holding a straight edge along the baseline. . Faculty, Students, State Boards & Volunteers. If you have any feedback on our Countdown to Intern Year series, please reach out to Samhita Nelamangala at [emailprotected] This depends on the source and duration of your increased heart rate. Your doctor evaluates the situation by reviewing fetal heart tracing patterns. Umbilical cord influences that can alter blood flow include true knots, hematomas, and the number of umbilical vessels. In addition, you must know what is causing each type of deceleration, such as uteroplacental insufficiency or umbilical cord compression. Back. A normal fetal heart tracing would reassure both you and your obstetrician that its safe to proceed with labor and delivery. Stillbirth and Gestational Diabetes: How to Lower Your Risk, Autism Risks Related to Pregnancy and Birth, Fetal heart monitoring in labour: From Pinard to artificial intelligence, FIGO consensus guidelines on intrapartum fetal monitoring: Cardiotocography, What happens if my prenatal doctor hears a fetal heart arrhythmia, External and internal heart rate monitoring of the fetus, Avoid fetal "keepsake" images, heartbeat monitors, Fetal tachycardia is an independent risk factor for chromosomal anomalies in firsttrimester genetic screening, Impact of maternal exercise during pregnancy on offspring chronic disease susceptibility, Effects of prenatal stress on pregnancy and human development: Mechanisms and pathways, Maternal intake of medications, caffeine, or nicotine, Maternal age (teens or women over age 35), A baby with health concerns or chromosomal abnormalities. The fetus in this tracing also has fetal tachycardia, or an elevated heart rate of 170 -175 beats per minute over a 10 minute period of time. This measurement helps healthcare providers determine the well-being of the fetus during prenatal visits or labor. - 160-200 generally well tolerated w normal variability, Contraction forces are usually reported as, montevideo units *(MVUs)*: represent *total intensity of each contraction over 10 min* period Monitoring fetal heart rate during pregnancy has been a focus for doctors and midwives since the 1800s. You must know how to identify early decelerations, late decelerations, and variable decelerations. UT Southwestern Medical Center. Health care professionals play the game to hone and test their EFM knowledge and skills. According to an executive from Vitalant, the largest nonprofit blood bank in the United States, as much as 80% of the blood supply is from vaccinated donors. *umbilical cord compression*, which can result from cord wrapping, fetal anomalies, or knots in cord *bpm = beats per minute. The second half of the *reflex late decels*: thought to be in response to vagal stimulation by chemoreceptors in fetal head in response to low oxygen Content adapted from relevant ACOG Practice Bulletins and AAFP Guidelines. Occasional use of Dopplers by a healthcare provider is considered safe. https://www.acog.org/~/media/For%20Patients/faq015.pdf. This may cause unnecessary worry for parents. Our proposed deep learning solution consists of three main components (see Fig. Decelerations represent a decrease in FHR of more than 15 bpm in bandwidth amplitude. Fetal heart tracing is a type of nonstress test that doesnt require any specific preparation. Avoid fetal "keepsake" images, heartbeat monitors. When using external fetal heart monitoring, the fetal heart rate is generally best found by placing the monitor over the fetal _____. Coussons-Read ME. ", "The Second Look files are phenomenal and were an excellent way to test my knowledge after I had studied a bit.". Management depends on the clinical picture and presence of other FHR characteristics.18, Overall Assessment (O). Impact of maternal exercise during pregnancy on offspring chronic disease susceptibility. She specializes in health and wellness writing including blogs, articles, and education. You can check out all our previous content here if you didnt get a chance to see it. ", "The Second Look was a fantastic review for the exam, for both structure and function. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Any type of abnormality spotted in a fetal heart tracing could indicate an inadequate supply of oxygen or other medical issues. Am I Having Depression During Pregnancy? What are the rate and duration of the contractions seen on this strip?What intervention would you take after evaluating this strip? Monique Rainford, MD, isboard-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. You are turning on Local Settings. -can start before, during or after contraction starts BASIC Fetal Heart Monitoring This workshop was developed for the RN with 0-6 months experience in L&D. The course will define methods of monitoring, instrumentation, physiology and pathophysiology of the FHR, FHR characteristics, as well as review common antenatal testing methods. Auscultation of the fetal heart rate (FHR) is performed by external or internal means. Bulk pricing was not found for item. Compare maternal pulse simultaneously with FHR, According to AWHONN, the normal baseline Fetal Heart Rate (FHR) is. Tracing patterns can and will change! doi:10.1136/hrt.2005.069369. The Fetal Heart Rate Tracing SecondLookTM app will display a prompt if new updates are available for download. 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). -transition: 8-10 cm. Describe the variability. Sometimes a fetal heart rate is outside the normal range simply because the fetus is moving around. The baseline will be stable with a ten-beat variability, for instance 120 to 130, or 134 to 144. Depending on your health status and your babys, nonstress tests (one to two times a week, if not daily) might be a good idea. The NCC EFM Tracing Game uses NICHD terminology. Differentiate maternal pulse from fetal pulse, 4. --bradycardia Abdomen. Montana's bill would ban donors who have received the mRNA vaccines from giving blood. Basic 5 areas to cover in FHR description: -mean FHR rounded to increments of 5bpm in 10 min segment, excluding: visually apparent increases (onset to peak in less than 30 seconds) in FHR from most recently calculated baseline, Stimulation of fetal scalp by digital exam should cause, HR acceleration in normal fetus w arterial fetal pH >7.2, Guidelines for intrapartum fetal monitoring: continuous electronic in low and high risk, *first stage: cervix thins and opens* It takes that professionals understanding of what the continuous tracings show to properly assess the fetal condition. A. This mobile app covers the following topics (2007). Injection Gone Wrong: Can You Spot The Mistakes? What reassuring sign is missing? (minimum essential medium alpha containing 10% fetal bovine serum, 100 U/mL penicillin, 100 mg . Compared with structured intermittent auscultation, a period of EFM on maternity unit admission results in a lack of improved neonatal outcomes and increased interventions, including epidural analgesia (NNH = 19), continuous EFM (NNH = 7), and fetal blood scalp testing (NNH = 45). Contractions are classified as normal (no more than five contractions in a 10-minute period) or tachysystole (more than five contractions in a 10-minute period, averaged over a 30-minute window).11 Tachysystole is qualified by the presence or absence of decelerations, and it applies to spontaneous and stimulated labor. 2013;6(2):52-57. doi:10.1177/1753495X12473751. Assess maternal vital signs (temperature, blood pressure, pulse), 3. All rights reserved. The perception that structured intermittent auscultation increases medicolegal risk, the lack of hospital staff trained in structured intermittent auscultation, and the economic benefit of continuous EFM from decreased use of nursing staff may promote the use of continuous EFM.8 Online Table A lists considerations in developing an institutional strategy for fetal surveillance. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Krebs HB, Petres RE, Dunn LJ. What Do Braxton Hicks Contractions Feel Like? Am J Obstet Gynecol 1981; 140:435. Baseline A baseline of less than 110 bpm is defined as bradycardia.11 Mild bradycardia (100 to 110 bpm) is associated with post-term infants and occipitoposterior position.15 Rates of less than 100 bpm may be seen in fetuses with congenital heart disease or myocardial conduction defects.15 A baseline greater than 160 bpm is defined as tachycardia11 (Online Figure B). or call toll-free from U.S.: (800) 762-2264 or (240) 547-2156 2015;131(1):13-24. doi:10.1016/j.ijgo.2015.06.019. BJOG: An International Journal of Obstetrics & Gynaecology. You scored 6 out of 6 correct. Patient information: See related handout on electronic fetal monitoring, written by the author of this article. 140 Correct . Click on the link below to ask for help or provide us feedback about this product. 1. Practice Quizzes 1-5 - Electronic Fetal Monitoring Basic and Advanced Study Home About Self Guided Tutorial EFM In-Depth Assessments Fetal Tracing Index References Practice Quizzes 1-5 Try your hand at the following quizzes. ET). Theyre empowered by these results to intervene and hopefully prevent an adverse outcome. This is most likely to be done in the late stages of your pregnancy and it might be combined with other tests to see if you have either diabetes or high blood pressure both of which can cause problems. External and internal heart rate monitoring of the fetus. It provides your healthcare team with information so they can intervene, if necessary. Fetal heart rate (FHR) Top line on monitor strip Uterine contractions Bottom line on monitor strip 8 Features to Describe Baseline Variability Accelerations Decelerations Trends over time Interpret into 1 of 3 categories 9 Baseline Mean fetal heart rate Rounded to increments of 5 During a 10 minute period Excluding accelerations and decelerations Prior . What kind of decelerations and variability does this strip show? 32 weeks EGA: peak 15 bpm above baseline, duration 15 seconds but < 2 minutes from onset of the acceleration to return to baseline. What are the two most important characteristics of the FHR? International Journal of Gynecology & Obstetrics. List three ways in which you can determine that an FHR pattern is pseudo sinusoidal and NOT sinusoidal. Remember, the baseline is the average heart rate rounded to the nearest five bpm. -acceleration in response means that acidosis is unlikely Structured intermittent auscultation is a technique that employs the systematic use of a Doppler assessment of fetal heart rate (FHR) during labor at defined timed intervals (Table 1).4 It is equivalent to continuous EFM in screening for fetal compromise in low-risk patients.2,3,5 Safety in using structured intermittent auscultation is based on a nurse-to-patient ratio of 1:1 and an established technique for intermittent auscultation for each institution.4 Continuous EFM should be used when there are abnormalities in structured intermittent auscultation or for high-risk patients (Table 2).4 An admission tracing of electronic FHR in low-risk pregnancy increases intervention without improved neonatal outcomes, and routine admission tracings should not be used to determine monitoring technique.6. From there, providers generally check it during each subsequent prenatal appointment and also monitor it during labor. -marked baseline variability, absence of induced accels after fetal stimulation, Periodic or episodic decels in category II, -recurrent variable decels w minimal-moderate baseline variability Hornberger, L. K., & Sahn, D. J. No. During labor, they may give the mother oxygen or change her position to see if that helps the baby or if they need to intervene. Together with Flo, learn how fetal heart tracing actually works. 100-170 bpm C. 110-160 bpm D. 120-140 bpm 2. A fetal heart rate gives you and your healthcare team information about your baby's health during pregnancy. Early. This technique is considered only after a mother's water has broken and the cervix is dilated or open. Create engaging Jeopardy-style quiz games in minutes or choose from millions of existing Jeopardy game templates. *MVUs >200 adequate* for 90% of labors to progress, -*tachysystole: 5+ contractions in 10 minutes* without evidence of fetal distress A concern with continuous EFM is the lack of standardization in the FHR tracing interpretation.5,811 Studies demonstrate poor inter-rater reliability of experts, even in controlled research settings.12,13 A National Institute of Child Health and Human Development (NICHD) research planning workshop was convened in 1997 to standardize definitions for interpretation of EFM tracing.14 These definitions were adopted by the American College of Obstetricians and Gynecologists (ACOG) in 2002,5 and revisions were made in a 2008 workshop sponsored by NICHD, ACOG, and the Society for Maternal-Fetal Medicine.11 The Advanced Life Support in Obstetrics (ALSO) curriculum developed the mnemonic DR C BRAVADO (Table 3) to teach a systematic, structured approach to continuous EFM interpretation that incorporates the NICHD definitions.9,11. Assessment of heart rate variability (HRV) is a sensitive indicator of autonomic nervous system function and is used in numerous fields of clinical medicine, including cardiology, neurology, and anesthesiology. Tachycardia is certainly not always indicative of fetal distress or hypoxia, but this fetal tracing is ominous. For more information on the use, interpretation and management of patients based on Fetal Heart Tracings check out the resources below. Continuous EFM reduced neonatal seizures (NNT = 661), but not the occurrence of cerebral palsy. --> decreased intervillous exchange of oxygen adn CO2 and progressive fetal hypoxia and acidemia, *abrupt, onset <30 sec* visually apparent decreases in FHR below baseline FHR duration Powered by Powered by Strongly predictive of normal acid-base status at the time of observation. By accessing any content on this site or its related media channels, you agree never to hold us liable for damages, harm, loss, or misinformation.