AND 100% CORRECT WELL DETAILED
What is the purpose of EFM? - ANSWER monitor how baby is doing and how he/she
will tolerate labor
Electronic Fetal Monitoring - ANSWER - fetal HR monitored w/ultrasound
- maternal ctx monitored w/pressure sensor
- sensors connected to recording machine --> print-out or view FHR and maternal CTX
together
- 89% of mothers have EFM at some point
- provides: minute-by-minute information on fetus, insight into stresses on fetus
Oxygen pathway - ANSWER oxygen pathway (environment, lungs, heart, vasculature,
uterus, placenta, cord) --> fetal response (hypoxemia, hypoxia, metabolic acidosis, metabolic
academia)
Limitation of electric fetal monitoring - ANSWER - monitoring is adjunct tool --> not
diagnostic
- overly optimistic --> most of the problems have already occurred by L&D
- provides information only on current acid-base status of the fetus
- one point in time --> tracings can and will change
- Outcomes --> EFM leads to increase overall C/S rate compared to intermittent auscultation,
increased risk vacuum and forceps delivery, reduced rate of neonatal seizures, does not
reduce risk of CP (cerebral palsy)
Types of fetal monitoring - ANSWER 1. Intermittent auscultation
1
, 2. Continuous fetal monitoring
- external --> ultrasound doppler
- internal --> fetal scalp electrode (reserved for concerns about baby)
External monitoring - ANSWER - consists of tocotransducer and ultrasound transducer
- measures uterine ctx and FHR
- Tototransducer provides info about --> frequency, duration, relative strength of
contractions
- DOES NOT give actual intrauterine pressure or anything about quality or intensity of
contractions
- indentability of uterine wall
1. Nose --> mild
2. Chin --> moderate
3. Forehead --> strong
Internal monitoring (when something bad happens) - ANSWER - consists of: spiral
electrode for FHR, IUPC (intrauterine pressure catheter)
- most precise method to monitoring FHR (beat to beat)
- placed during vaginal exam (cervix must be dilated at least 2cm, must have ROM,
accessible presenting part)
- contraindications: mom declines, moms with hepatitis, HIV, preterm babies (risk of
ventricular hemorrhage)
- electrode removed prior to birth
____________________ is the time between the beginning of one contraction and the
beginning of the next contraction - ANSWER frequency
______________ is the number of contractions in a 10 minutes period -
ANSWER number
2
What is the purpose of EFM? - ANSWER monitor how baby is doing and how he/she
will tolerate labor
Electronic Fetal Monitoring - ANSWER - fetal HR monitored w/ultrasound
- maternal ctx monitored w/pressure sensor
- sensors connected to recording machine --> print-out or view FHR and maternal CTX
together
- 89% of mothers have EFM at some point
- provides: minute-by-minute information on fetus, insight into stresses on fetus
Oxygen pathway - ANSWER oxygen pathway (environment, lungs, heart, vasculature,
uterus, placenta, cord) --> fetal response (hypoxemia, hypoxia, metabolic acidosis, metabolic
academia)
Limitation of electric fetal monitoring - ANSWER - monitoring is adjunct tool --> not
diagnostic
- overly optimistic --> most of the problems have already occurred by L&D
- provides information only on current acid-base status of the fetus
- one point in time --> tracings can and will change
- Outcomes --> EFM leads to increase overall C/S rate compared to intermittent auscultation,
increased risk vacuum and forceps delivery, reduced rate of neonatal seizures, does not
reduce risk of CP (cerebral palsy)
Types of fetal monitoring - ANSWER 1. Intermittent auscultation
1
, 2. Continuous fetal monitoring
- external --> ultrasound doppler
- internal --> fetal scalp electrode (reserved for concerns about baby)
External monitoring - ANSWER - consists of tocotransducer and ultrasound transducer
- measures uterine ctx and FHR
- Tototransducer provides info about --> frequency, duration, relative strength of
contractions
- DOES NOT give actual intrauterine pressure or anything about quality or intensity of
contractions
- indentability of uterine wall
1. Nose --> mild
2. Chin --> moderate
3. Forehead --> strong
Internal monitoring (when something bad happens) - ANSWER - consists of: spiral
electrode for FHR, IUPC (intrauterine pressure catheter)
- most precise method to monitoring FHR (beat to beat)
- placed during vaginal exam (cervix must be dilated at least 2cm, must have ROM,
accessible presenting part)
- contraindications: mom declines, moms with hepatitis, HIV, preterm babies (risk of
ventricular hemorrhage)
- electrode removed prior to birth
____________________ is the time between the beginning of one contraction and the
beginning of the next contraction - ANSWER frequency
______________ is the number of contractions in a 10 minutes period -
ANSWER number
2
