Page 202 - كتاب تمريض نسا الاكتروني
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               1-  Internal fetal monitoring
               2-  External fetal monitoring

            Internal fetal monitoring:

           Definition:

           *An electrode is attached to the fetal ECG Invasive
               •  Internal monitoring can't be used unless the cervix dilated and the membranes are
                  ruptured to allow replacement of the scalp.

               •  The ultrasound probe (transducer) is applied to the mother's abdominal wall. It
                  detects movement of fetal cardiac valves or movement of blood in the fetal heart and
                  vessels


             Technique:

            • Internal monitoring can't be used unless the cervix dilated and the membranes are
           ruptured to allow replacement of the scalp.

            • It requires cervical dilation at least 2cm to allow replacement of the scalp.
            • Presenting part is low enough to allow placement of scalp.
            • High skilled practitioner should be present and use aseptic technique.

            • Placement a spiral electrode into fetal presenting part usually head to assess  FHR and
           record uterine contraction.



            Advantage:

           1) more accurate in displaying an FHR between 30 and 240 b/min.


             Disadvantages:
            1) Perforation of uterus or placenta of fetal damage due to misapplication in fetal
           presentation wasn’t recognized.

           2) Carry the risk of infection of scalp or amnion.
           3) The insertion of electrode may cause bruising on the part of fetus that electrode is

           attached.
            4) Insertion of electrode may be un comfortable for mother.



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