Page 71 - 2023 Elctronic Book (3) Normal Labor_Neat

− 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
• Provide documentation of labor

Types of fetal monitoring:

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.

70