The interaction between these systems results in a difference in the beat-to-beat intervals resulting in variability of the fetal heart rate tracing. In the term fetus, moderate variability is considered normal as it indicates a normally functioning central nervous system. During the first several pushes, the EFM demonstrated an initial heart rate deceleration, and a loss of signal, but the heart rate returned to a baseline rate of 150 BPM. With the patient’s continued pushing efforts, the EFM baseline increased to 180 BPM, with evidence of variable decelerations to a nadir of 120 BPM, although with some signal gaps ( FIGURE 1, red arrow). Electronic Fetal Monitoring: •Fetal heart sounds were first reported in the 1600’s •In the 1800’s, again described and used to determine viability and fetal lie. •1917 David Hillis in Chicago described the fetoscope, but in 1922 Joseph DeLee took the credit!

The interaction between these systems results in a difference in the beat-to-beat intervals resulting in variability of the fetal heart rate tracing. In the term fetus, moderate variability is considered normal as it indicates a normally functioning central nervous system. minutes is a baseline change > 32 weeks 15 x 15 < 32 weeks 10 x 10 ACOG PB #106 Reading EFM •Baseline •Variability •Accelerations •Decelerations (next lecture) •Contractions Uterine Contractions • External tocodynamometer –Frequency and duration of contractions –Noninvasive but uncomfortable, difficult to monitor obese patients tronic fetal monitoring documentation and liability-reduction strategies for perinatal nurses. Key Words: electronic fetal monitoring documentation, fetal heart rate charting, perinatal documentation, health information technology in obstetrics, perinatal liability D ocumentation has always been an indispens-able part of professional nursing Notably, fetal baseline heart rate is higher, averaging at 155 between 20–24 weeks (compared to a term fetus where average baseline fetal heart rate is 140). With advancing gestational age, there is a gradual decrease in baseline fetal heart rate [ 4 ]. An electronic fetal monitor is used to detect abnormally rapid or slow rates (less than 110 or more than 160 beats/min) at term. baseline fetal heart rate. The average range of beats per minute recorded within a 10-min time frame. The normal range is between 120 and 160 beats per minute. Peak must be ≥15 bpm, must last ≥15 seconds, but <2 minutes from the onset to return. Before 32 weeks of gestation, accelerations are defined as having a peak ≥10 bpm and duration of ≥10 seconds. Acceleration ≥2 minutes but <10 minutes in duration. Acceleration lasting ≥10 minutes is defined as a baseline change.

Electronic Fetal Monitoring: •Fetal heart sounds were first reported in the 1600’s •In the 1800’s, again described and used to determine viability and fetal lie. •1917 David Hillis in Chicago described the fetoscope, but in 1922 Joseph DeLee took the credit!

decrease in baseline rate; inhibition of increasing accelerations as gestational age advances. Terbutaline. Increase in baseline rate . Zidovudine. No change. Derived from: American College of Obstetricians and Gynecologists (2009). Intrapartum fetal heart rate monitoring: Nomenclature, interpretation, and general management principles. Definitions of Fetal Heart Rate Patterns. Baseline fetal heart rate is the average fetal heart rate (FHR) rounded to increments of 5 beats per minute during a 10-minute segment, excluding periodic or episodic changes, periods of marked variability, or baseline segments that differ by more than 25 beats per minute. Fetal heart rate monitoring is the process of checking the condition of your fetus during labor and delivery by monitoring your fetus's heart rate with special equipment. Why is fetal heart rate monitoring done during labor and delivery? Fetal heart rate monitoring may help detect changes in the normal heart rate pattern during labor. The monitor is assessing the baseline fetal heart rate and how it changes with contractions. It records any increases in the fetal heart rate (accelerations) and any decreases (decelerations), as well as the frequency and duration of the mother’s uterine contractions (Smith et al. 2016). Normal baseline heart rate: About 110 to 160 beats per minute. Bradycardia: A decrease in the fetal heart rate from baseline to below 110 beats per minute that lasts for more than ten minutes. Tachycardia: An increase in the fetal heart rate to above 160 beats per minute for more than ten minutes. Identify the baseline heart rate. Locate the number of beats per minute on the top section of the fetal monitor strip. A range of 120 to 160 beats per minute indicates a normal fetal heart rate but a deviation, or change, of 10 beats or less in your baby’s heart rate is normal. The interaction between these systems results in a difference in the beat-to-beat intervals resulting in variability of the fetal heart rate tracing. In the term fetus, moderate variability is considered normal as it indicates a normally functioning central nervous system.

In the RANZCOG Fetal Surveillance Education Program (FSEP) we refer to the With a baseline fetal heart rate of 90–95bpm, normal baseline variability and 

An electronic fetal monitor is used to detect abnormally rapid or slow rates (less than 110 or more than 160 beats/min) at term. baseline fetal heart rate. The average range of beats per minute recorded within a 10-min time frame. The normal range is between 120 and 160 beats per minute.

The baseline FHR is the heart rate during a 10 minute segment rounded to the nearest 5 beat per minute increment excluding periods of marked FHR variability,  

Baseline Fetal Heart Rate (FHR): The baseline FHR is the heart rate during a 10 minute segment rounded to the nearest 5 beat per minute increment excluding periods of marked FHR variability, periodic or episodic changes, and segments of baseline that differ by more than 25 beats per minute. The minimum baseline duration must be at least 2 minutes. The normal FHR baseline should range between 110 beats/min to 160 beats/min. The baseline FHR is normally set by the atrial pacemaker and the beat-to-beat differences in the heart rate are governed by a balance between the sympathetic and parasympathetic branches of the autonomic nervous system. FHR baseline with a cycle frequency of 3-5 per minute which persists for 20 minutes or more. From the National Institute of Child Health and Human Development Research Planning Workshop: Electronic fetal heart rate monitoring: Research guidelines for interpretation, 1997. ACOG Practice Bulletin #70, 2005: Intrapartum Fetal Heart Rate Monitoring. The interaction between these systems results in a difference in the beat-to-beat intervals resulting in variability of the fetal heart rate tracing. In the term fetus, moderate variability is considered normal as it indicates a normally functioning central nervous system. During the first several pushes, the EFM demonstrated an initial heart rate deceleration, and a loss of signal, but the heart rate returned to a baseline rate of 150 BPM. With the patient’s continued pushing efforts, the EFM baseline increased to 180 BPM, with evidence of variable decelerations to a nadir of 120 BPM, although with some signal gaps ( FIGURE 1, red arrow). Electronic Fetal Monitoring: •Fetal heart sounds were first reported in the 1600’s •In the 1800’s, again described and used to determine viability and fetal lie. •1917 David Hillis in Chicago described the fetoscope, but in 1922 Joseph DeLee took the credit!

Chronic hypoxia presents as a baseline rate at the upper end of normal associated with reduced variability and blunted responses (shallow decelerations). This 

The FHR baseline value is defined as the approximate heart rate between uterine contractions. The normal range is 110–160 bpm. Baseline rates below this  Continuous electronic fetal heart rate (FHR) monitoring was developed in the 6 –25 bpm]), normal baseline [110–160 bpm] and absence of decelerations), and  A baseline fetal heart rate of 110–160 bpm. Absence of late or variable FHR decelerations. Moderate FHR variability (6–25 bpm). Early decelerations may be  

Fetal heart rate baseline: one of the first things to appreciate is how fast the fetal heart rate is at  Baseline Fetal Heart Rate (FHR): The baseline FHR is the heart rate during a 10 minute segment rounded to the nearest 5 beat per minute increment excluding periods of marked FHR variability, periodic or episodic changes, and segments of baseline that differ by more than 25 beats per minute. The minimum baseline duration must be at least 2 minutes.