Professional Documents
Culture Documents
Non-Invasive Antepartum Assessment of Fetal Well-Being: General Profile of Maternal Health
Non-Invasive Antepartum Assessment of Fetal Well-Being: General Profile of Maternal Health
Non-Invasive Antepartum Assessment of Fetal Well-Being: General Profile of Maternal Health
The direct parasympathetic pathways are via the vagal A decrease in FHR with reference to uterine contractions.
nuclei and the afferent cardiac vagal fibers. The direct It has 3 categories:
sympathetic control travels from the cardioregulatory
EARLY DECELERATION (head compression)
center to the spinal cord, the cervical and thoracic
sympathetic ganglia then to the fetal heart via the cardiac VARIABLE DECELERATION (cord compression)
sympathetic fibers. The indirect control is via sympathetic
LATE DECELERATION (uteroplacental insufficiency)
discharge and release of catecholamines from the fetal
adrenals.
ELECTRONIC FETAL HEART RATE: BASIC Similar to early deceleration but the timing is delayed,
PATTERNS 30 seconds or more after the onset of the contraction.
The nadir occurs after the contraction peak and return to
baseline when the contraction is over.
BASELINE FHR
The approximate mean fetal heart rate over a VARIABLE DECELERATION (CORD COMPRESSION)
10-minute segment excluding decelerations, Abrupt decrease in FHR below baseline varies in shape,
accelerations and periods of marked variability. NORMAL duration, depth and timing, can occur with or without
VALUE: 110-160 BPM contractions; shapes can present as U, V, or W. Variable
FHR BRADYCARDIA: VALUES LESS THAN 110 BPM decelerations are classified as MILD, MODERATE or
SEVERE.
FHR TACHYCARDIA: VALUES MORE THAN 160 BPM
MILD VARIABLE DECELERATIONS: have a duration of
less than 30 seconds, regardless of level or a deceleration
below 70-80 bpm, regardless of duration.
VARIABILITY
MODERATE VARIABLE have a level less than 80 bpm
Fluctuations above and below the FHR baseline; 4 regardless of duration
categories used to quantify variability are the following:
2. Hypoxia/ Acidosis
SINUSOIDAL PATTERN
3. Extreme prematurity
1. Stable baseline heart rate 120-160 bpm with regular
oscillations 4. Congenital anomalies
3. Frequency of 2-5 cycles/ min (as long term variability) 6. Preexisting neurological abnormality
4. Fixed or flat short term variability 7. Drugs: CNS depressants, parasympatholytics (atropine),
beta-blockers
5. Change of FHR accelerations
2. Cocaine
INTERPRETATION:
3. Morphine
NEGATIVE TEST: 3 uterine contractions in a 10 minute
4. Sedatives period without late decelerations; average baseline
variability and accelerations of FHR with fetal movements
5. Alcohol
CST is repeated weekly unless there are some changes in 4. Fetal tone, FT (one or more episodes of extension of a
the clinical situation such as deterioration in diabetic fetal extremity with return to flexion or opening and
control, worsening hypertension and decreased fetal closing of hand within 30 minutes)
movement. 5. Amniotic fluid volume (single vertical pocket >2cm or
Equivocal test results should be repeated the next day. AFI>5cm)
Positive results are acted on in the context of the clinical
condition and verified by biophysical profile.
INTERPRETATION