Complete PDF file Updated.
, Quick Reference Guide
● ABCDs of intrapartum FHR management, 150
● Differential factors that may influence FHR, 108
● Evaluation of uterine activity during labor, 85
● Fetal oxygenation pathway, 11
● Fetal response to interrupted oxygenation, 11
● NICHD FHR categories, 106–107
● NICHD FHR definitions, 105–106
● Normal values for fetal cord blood gases, 164
● Sample FHR tracings with definitions and interpretation, 291–331
● Scientific levels of evidence, 108
● Standardized FHR interpretation, 140
● Standardized intrapartum FHR management algorithm, 148
Complete PDF file Updated.
, PREFACE
We are proud to continue nursing, midwifery, and physician collab-
oration in this new ninth edition of Mosby’s® Pocket Guide to Fetal
Monitoring: A Multidisciplinary Approach, consistent with the inter-
and intradisciplinary approach all of us bring to teaching this subject
matter. Diligently revised, this new edition continues to emphasize
standardized terminology and an evidence-based approach to inter-
pretation and management. This text remains a key resource for the
most clinically useful information for clincians of all levels on every
aspect of fetal monitoring, including intermittent auscultation, assess-
ment and management of uterine activity, and the crucial role of both
communication and documentation in risk management related to fetal
monitoring. Whether your practice is office-based, in a birth center, in a
hospital serving the community, or in an academic tertiary care center,
this text provides a relevant and easily understood reference for daily
clinical practice as well as clinician orientation and ongoing education.
DESCRIPTION
Primarily an oxygen monitor, the electronic fetal monitor is a tool
used to prevent fetal injury resulting from interruption of fetal oxy-
genation, whether used during labor or in the antepartum period. Key
to this goal is standardization and simplification of clinical practices
related to interpretation and management of fetal monitoring. This
book provides clinicians with the tools needed to understand both
the strengths and the weaknesses of both electronic fetal monitoring
(EFM) and intermittent auscultation; as well as apply a collaborative
approach to clinical practice that is evidence- and consensus-based.
After a brief overview of the history of fetal monitoring, the text pro-
vides core clinical information on the physiologic basis for monitor-
ing, reviews the newest instrumentation for uterine and fetal heart
rate (FHR) monitoring, including the newer abdominal “patch”
technology, and identifies key factors in the evaluation of uterine
activity. In keeping with maintaining the legal standard of care in
the United States, the National Institute of Child Health and Human
Development (NICHD) definitions are presented and reviewed, and
a standardized approach to interpretation and management is clearly
outlined. The influence of gestational age on FHR is examined, along
with the evaluation of fetal status outside the obstetric unit and in
the antenatal setting. Documentation and risk management issues are
v
Complete PDF file Updated.
, vi Preface
delineated, including issues of informed consent in choice of moni-
toring modality. An overview of fetal monitoring in Europe provides
clinicians with a look at fetal monitoring outside the United States.
Patient safety, communication, and clinical collaboration are the cor-
nerstones of each chapter, and suggestions for practice improvement
make this edition an invaluable resource for the busy clinician.
FEATURES
This book has a number of distinctive features:
n Content is organized in a manner that allows clinicians to build
on key fundamental concepts and progress logically to advanced
principles, making the text suitable for novices needing basic
information as well as experienced practitioners seeking greater
insight into clinical practice issues.
n Critical information is highlighted using illustrations, tables, and
illustrative fetal monitor tracings.
n FHR characteristics are explained and the supporting level of evi-
dence is provided, revealing a number of common myths regard-
ing fetal monitoring.
n Evidence levels are provided for information regarding various
FHR patterns, and several common obstetric myths are laid to rest.
n Appendices now include self-assessment questions as well as
fetal monitor tracings for practice in application of the NICHD
definitions and principles of standardized interpretation.
ORGANIZATION
Chapter 1 traces the history of fetal monitoring from the use of aus-
cultation in the 17th century to present-day practice and includes
a discussion of the resurgence of intermittent auscultation for fetal
monitoring in low-risk women.
Chapter 2 provides a review of the physiologic basis for monitor-
ing. The oxygen pathway is discussed, as well as the fetal response
to interrupted oxygenation. These core physiologic concepts provide
clinicians with the fundamentals of fetal oxygenation that serve as
the basis for current practice.
Chapter 3 offers a detailed look at instrumentation for both inter-
mittent auscultation and EFM, including newer approaches such as
abdominal electrocardiogram and new display options for dopplers
used in intermittent auscultation. Both external and internal moni-
toring devices and their application are covered in depth, including
artifact detection, telemetry, and troubleshooting tips.
Complete PDF file Updated.
, Quick Reference Guide
● ABCDs of intrapartum FHR management, 150
● Differential factors that may influence FHR, 108
● Evaluation of uterine activity during labor, 85
● Fetal oxygenation pathway, 11
● Fetal response to interrupted oxygenation, 11
● NICHD FHR categories, 106–107
● NICHD FHR definitions, 105–106
● Normal values for fetal cord blood gases, 164
● Sample FHR tracings with definitions and interpretation, 291–331
● Scientific levels of evidence, 108
● Standardized FHR interpretation, 140
● Standardized intrapartum FHR management algorithm, 148
Complete PDF file Updated.
, PREFACE
We are proud to continue nursing, midwifery, and physician collab-
oration in this new ninth edition of Mosby’s® Pocket Guide to Fetal
Monitoring: A Multidisciplinary Approach, consistent with the inter-
and intradisciplinary approach all of us bring to teaching this subject
matter. Diligently revised, this new edition continues to emphasize
standardized terminology and an evidence-based approach to inter-
pretation and management. This text remains a key resource for the
most clinically useful information for clincians of all levels on every
aspect of fetal monitoring, including intermittent auscultation, assess-
ment and management of uterine activity, and the crucial role of both
communication and documentation in risk management related to fetal
monitoring. Whether your practice is office-based, in a birth center, in a
hospital serving the community, or in an academic tertiary care center,
this text provides a relevant and easily understood reference for daily
clinical practice as well as clinician orientation and ongoing education.
DESCRIPTION
Primarily an oxygen monitor, the electronic fetal monitor is a tool
used to prevent fetal injury resulting from interruption of fetal oxy-
genation, whether used during labor or in the antepartum period. Key
to this goal is standardization and simplification of clinical practices
related to interpretation and management of fetal monitoring. This
book provides clinicians with the tools needed to understand both
the strengths and the weaknesses of both electronic fetal monitoring
(EFM) and intermittent auscultation; as well as apply a collaborative
approach to clinical practice that is evidence- and consensus-based.
After a brief overview of the history of fetal monitoring, the text pro-
vides core clinical information on the physiologic basis for monitor-
ing, reviews the newest instrumentation for uterine and fetal heart
rate (FHR) monitoring, including the newer abdominal “patch”
technology, and identifies key factors in the evaluation of uterine
activity. In keeping with maintaining the legal standard of care in
the United States, the National Institute of Child Health and Human
Development (NICHD) definitions are presented and reviewed, and
a standardized approach to interpretation and management is clearly
outlined. The influence of gestational age on FHR is examined, along
with the evaluation of fetal status outside the obstetric unit and in
the antenatal setting. Documentation and risk management issues are
v
Complete PDF file Updated.
, vi Preface
delineated, including issues of informed consent in choice of moni-
toring modality. An overview of fetal monitoring in Europe provides
clinicians with a look at fetal monitoring outside the United States.
Patient safety, communication, and clinical collaboration are the cor-
nerstones of each chapter, and suggestions for practice improvement
make this edition an invaluable resource for the busy clinician.
FEATURES
This book has a number of distinctive features:
n Content is organized in a manner that allows clinicians to build
on key fundamental concepts and progress logically to advanced
principles, making the text suitable for novices needing basic
information as well as experienced practitioners seeking greater
insight into clinical practice issues.
n Critical information is highlighted using illustrations, tables, and
illustrative fetal monitor tracings.
n FHR characteristics are explained and the supporting level of evi-
dence is provided, revealing a number of common myths regard-
ing fetal monitoring.
n Evidence levels are provided for information regarding various
FHR patterns, and several common obstetric myths are laid to rest.
n Appendices now include self-assessment questions as well as
fetal monitor tracings for practice in application of the NICHD
definitions and principles of standardized interpretation.
ORGANIZATION
Chapter 1 traces the history of fetal monitoring from the use of aus-
cultation in the 17th century to present-day practice and includes
a discussion of the resurgence of intermittent auscultation for fetal
monitoring in low-risk women.
Chapter 2 provides a review of the physiologic basis for monitor-
ing. The oxygen pathway is discussed, as well as the fetal response
to interrupted oxygenation. These core physiologic concepts provide
clinicians with the fundamentals of fetal oxygenation that serve as
the basis for current practice.
Chapter 3 offers a detailed look at instrumentation for both inter-
mittent auscultation and EFM, including newer approaches such as
abdominal electrocardiogram and new display options for dopplers
used in intermittent auscultation. Both external and internal moni-
toring devices and their application are covered in depth, including
artifact detection, telemetry, and troubleshooting tips.
Complete PDF file Updated.
