Maternal Newborn Assessment: Fetal Heart Monitoring

Maternal Newborn Assessment

Fetal Heart Monitoring

• Purpose: To assess fetal well-being and detect any potential complications during pregnancy and labor.
• Methods:
  • External Fetal Monitoring: Utilizes ultrasound transducers placed on the mother’s abdomen to measure fetal heart rate (FHR).
  • Internal Fetal Monitoring: Involves placing a small electrode on the fetal scalp to provide more accurate FHR readings.
• Normal Fetal Heart Rate: 110-160 beats per minute.
• Variability: Indicates fetal well-being; categorized as:
  • Absent: 0 bpm variability.
  • Minimal: <5 bpm variability.
  • Moderate: 6-25 bpm variability (normal).
  • Marked: >25 bpm variability.
• Accelerations: Temporary increases in FHR, typically a sign of fetal well-being.
• Decelerations: Temporary decreases in FHR categorized as:
  • Early: Associated with contractions; indicates head compression.
  • Variable: Abrupt decreases; may indicate cord compression.
  • Late: Occurs after contraction; suggests uteroplacental insufficiency.
• Continuous vs. Intermittent Monitoring: Continuous provides ongoing assessment, while intermittent checks are done at intervals.

Maternal Health History

• Importance: Establishes a baseline for maternal health and identifies risk factors for complications.
• Components to Assess:
  • Medical History: Previous surgeries, chronic illnesses (e.g., diabetes, hypertension).
  • Obstetric History: Number of pregnancies, outcomes (live births, miscarriages), gestational age at delivery, any complications in previous pregnancies.
  • Family History: Genetic disorders, pregnancy-related complications (e.g., preeclampsia).
  • Social History: Substance use (tobacco, alcohol, drugs), support systems, socioeconomic factors.
  • Current Medications: Prescription drugs, over-the-counter medications, herbal supplements.
  • Gynecological History: Menstrual cycle regularity, history of STIs, contraceptive use.
• Risk Assessment: Identifying high-risk conditions that might require closer monitoring or intervention during pregnancy and childbirth.

Fetal Heart Monitoring

• Objective: Assess fetal well-being, identify potential complications during pregnancy and labor.
• External Fetal Monitoring: Employs ultrasound transducers on the mother's abdomen to track fetal heart rate (FHR).
• Internal Fetal Monitoring: Involves an electrode on the fetal scalp for precise FHR measurements.
• Normal FHR Range: Typically between 110-160 beats per minute.
• Variability: Reflects fetal health; assessed as:
  • Absent Variability: No fluctuations (0 bpm).
  • Minimal Variability: Small fluctuations (up to 25 bpm).
• Accelerations: Temporary FHR spikes, generally indicating a healthy fetal condition.
• Decelerations: Temporary drops in FHR classified into:
  • Early Decelerations: Happen with contractions, suggest head compression.
  • Variable Decelerations: Sudden drops, potentially signal cord compression.
  • Late Decelerations: Occur after contractions, indicating possible uteroplacental insufficiency.
• Monitoring Approach: Continuous monitoring offers real-time assessment; intermittent monitoring occurs at set intervals.

Maternal Health History

• Significance: Establishes maternal health baseline and identifies risks for complications.
• Medical History Review: Includes past surgeries and chronic conditions like diabetes and hypertension.
• Obstetric History Evaluation: Focus on the number of pregnancies, outcomes (live births/miscarriages), gestational ages, and previous complications.
• Family History Inquiry: Assess for genetic disorders and any pregnancy-related complications (e.g., preeclampsia).
• Social History Consideration: Looks into substance use (tobacco, alcohol, drugs), social support, and economic status.
• Current Medications Review: Lists all medications, including prescriptions, over-the-counter drugs, and herbal supplements.
• Gynecological History Assessment: Evaluates menstrual cycle regularity, STI history, and contraceptive usage.
• Risk Assessment: Identifies conditions needing closer monitoring or interventions during pregnancy and childbirth.

Explore the essential techniques of fetal heart monitoring to assess fetal well-being during pregnancy and labor. This quiz covers external and internal monitoring methods, normal heart rate ranges, variability types, and the significance of accelerations and decelerations. Test your knowledge on this crucial aspect of maternal newborn care.