Electronic Fetal Monitoring (EFM)
How many parts are there to the fetal heart tracing (FHT)?
There are 2 parts:
1. Fetal heart rate
Can be measured internally or externally:
- Externally - measured with a doppler
- Internally - measured with a fetal scalp electrode (FSE)
2. Tocodynamoter (Toco)
Measures mom's contractions
Can measured internally or externally:
- External - measured with a skin tensometer belt ('toco' belt)
- External shows the frequency of contractions
- Internally - measured with Intrauterine Pressure Catheter (IUPC)
- Internal shows frequency and strength of contractions
The Display
- Upper pane = baby (fetal heart tracing)
- Lower pane = mom (uterine activity)
- Fetal heart rate is displayed numerically and by increments of 10 bpm (ascending order)
- Uterine pressure is displayed numerically in mmHG
- Red lines = intervals of 1 min
- Baseline of FHR is average FHR over 10 minutes, rounded to the nearest 5 bpm. (will
always end in 5 or 0)
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Baseline FHR
the average FHR over 10 minutes, rounded to the nearest 5 bpm
Reactive NST
2 accelerations in a 20 min span along with moderate variability
Acme
resting period
VEAL CHOP
V- Variable C- Cord Comphression
E- Early Decels H- Head Compression
A- Accelerations O - OK
L- Late Decels P - Placenta insufficiency
Variability
Variability: Fluctuations in the FHR of 2 cycles per min. or greater
- MOST important indicator of fetal oxygen status
- Variability is caused by the interplay between sympathetic and parasympathetic systems
- Clinically, comments on variability should be based upon the last 10-20 minutes of tracing
absent Variability
Amplitude range that is undetectable (flat line)
minimal variability
amplitude range detectable at 5 bpm or fewer
moderate variability
How many parts are there to the fetal heart tracing (FHT)?
There are 2 parts:
1. Fetal heart rate
Can be measured internally or externally:
- Externally - measured with a doppler
- Internally - measured with a fetal scalp electrode (FSE)
2. Tocodynamoter (Toco)
Measures mom's contractions
Can measured internally or externally:
- External - measured with a skin tensometer belt ('toco' belt)
- External shows the frequency of contractions
- Internally - measured with Intrauterine Pressure Catheter (IUPC)
- Internal shows frequency and strength of contractions
The Display
- Upper pane = baby (fetal heart tracing)
- Lower pane = mom (uterine activity)
- Fetal heart rate is displayed numerically and by increments of 10 bpm (ascending order)
- Uterine pressure is displayed numerically in mmHG
- Red lines = intervals of 1 min
- Baseline of FHR is average FHR over 10 minutes, rounded to the nearest 5 bpm. (will
always end in 5 or 0)
Previous
Play
Next
, Rewind 10 seconds
Move forward 10 seconds
Unmute
0:00
/
0:15
Full screen
Brainpower
Read More
Baseline FHR
the average FHR over 10 minutes, rounded to the nearest 5 bpm
Reactive NST
2 accelerations in a 20 min span along with moderate variability
Acme
resting period
VEAL CHOP
V- Variable C- Cord Comphression
E- Early Decels H- Head Compression
A- Accelerations O - OK
L- Late Decels P - Placenta insufficiency
Variability
Variability: Fluctuations in the FHR of 2 cycles per min. or greater
- MOST important indicator of fetal oxygen status
- Variability is caused by the interplay between sympathetic and parasympathetic systems
- Clinically, comments on variability should be based upon the last 10-20 minutes of tracing
absent Variability
Amplitude range that is undetectable (flat line)
minimal variability
amplitude range detectable at 5 bpm or fewer
moderate variability
