Page 74 - 33Elctronic Book (3) Normal Labor

1- Differentiate between internal and external cardiotocography.

2- Differentiate between different methods of assessing fetus during labor.
III- Practical skills:
1- Apply nursing care for woman with abnormal fetal heart rate.

2- Demonstrate procedure of fetal monitoring (internal or external).
IV- General and transferable skills:
1) Cooperate with other health care team to manage woman with abnormal fetal heart rate.
2) Value importance of fetal monitoring during labor.

Definition:
Electronic fetal monitoring involves the use of an electronic fetal heart rate monitor to

record the baby's heart rate…. Electronic fetal monitoring is performed late in pregnancy
or continuously during labor to ensure normal delivery of health baby.

Indications for continuous electronic fetal monitoring:
▪ Antenatal maternal risk factors:

− Previous caesarean section.
− Pre- eclampsia or pregnancy- induced hypertension.
− Recurrent antepartum hemorrhage.
− Prolonged membrane rupture (> 24 hours).

− Diabetes.
− BMI at booking > 35 Kg/ m2
▪ Antenatal fetal risk factors:

− Suspected fetal grow resistance.

− Suspected oligohydramnios or Polyhydramnios.
− Abnormal presentation breech, transverse oblique

− High or free head in nulliparous woman.
− Reduced fetal move in the previous 24 hours.
− Other significant maternal medical disease or risk Factor requiring obstetric, including

prematurity and multi pregnancies.

The Goal of Electronic fetal monitoring (EFM) is:

• Reduce fetal death
• Reduce brain injury

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