Page 76 - 2023 Elctronic Book (3) Normal Labor_Neat

7-Sinusoidal pattern:

it indicates fetal anemia as in case of ruptured vasa praevia, feto maternal haemorrhage,
twin-to-twin transfusion syndrome, and Rh-immunization.
Causes:

- Acute intra partum asphyxia.
- Fetal maternal hemorrhage.
- Chronic fetal anemia.
Management:

-Continuous, careful, fetal assessment including direct ultrasound observation of fetal
abnormalities or placental abnormalities.

- Assessment for active fetal movement is important in assessing fetal status.
- Percutaneous umbilical blood sampling under ultrasound guidance is a technique that
permits fetal hemoglobin levels to be assessed.
- Preparations for a possible emergent delivery should be initiated if intrauterine

resuscitation is not appropriate.

 Method of electronic fetal monitoring

I-External fetal monitoring

Equipment:
1- Bedside monitor unit
2- Two transducer or sensor (one sensor for FHR and the other one for uterine activity)

3- Paper strip
4- Belts to hold the sensors or transducer.
5- Ultra sound Gel.

1) Hand washing
2) Prepare equipment

3) Keep privacy
4) Explain the procedure and teach the mother that using electronic monitoring does not
mean that you or the baby has a problem- it's a common way we assess the baby's response
to labor contraction.

5) Verify doctor order.
6) use Leopold’s maneuver or grips To locate the fetus back
7) Apply ultra sound gel to the transducer as gel improues the transmission of ultra sound

wave.
8) Place the transducer on the woman's abdomen at approximately of fetal back, move the

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