Used by all members of the obstetric team nurses, students, midwives, and physicians it is the primary method to assess fetal oxygenation in both the antepartum and intrapartum setting. Practice bulletin number 145, july 2014 replaces practice bulletin number 9, october 1999 clinical management guidelines for obstetriciangynecologists the american college of. The cardiotocogram ctg trace forms a central piece of documentary evidence in medicolegal cases related to intrapartum hypoxia and birth asphyxia. Which nursing action indicates the proper evaluation of this situation. Register for a free account existing user log in existing user log in. Fetal health surveillance instructor update work of the national fetal health surveillance steering committee the national fetal health surveillance steering committee n fhs sc has had a busy and productive year. Purpose and scope the purpose of this guideline is to reduce adverse perinatal outcomes related to inappropriate or inadequate intrapartum fetal surveillance. Pdf intrapartum fetal surveillance case based learning. Antenatal fetal assessment or surveillance is used to improve outcomes and decrease perinatal mortality. Goal the timely identification and rescue of the fetus at risk of neonatal and long term morbidity from intrapartum hypoxic insult 3. Intrapartum fetal health surveillance the nurses registered and nurse practitioners regulation. Obstetrics and gynecology at a glance, 4th edition wiley.
Google scholar schifrin bs, foye g, amato j, kates r, mackenna j. It is an evolving field, and it is no longer acceptable just to wait and see when problems arise in pregnancy. Sep 01, 2000 the american college of obstetricians and gynecologists acog has developed guidelines on antepartum fetal surveillance. A free powerpoint ppt presentation displayed as a flash slide show on id. Higherrisk mothers will be seen in hospital antenatal clinics often. Fundamentals of fetal health surveillance online manual target audience. Two basic approaches are taken to intrapartum fetal surveillancelowtech and hightech approaches. Advanced maternal age and the risk of antepartum stillbirth. Antepartum fetal surveillance techniques based on assessment of fetal heart rate fhr patterns have been in clinical use for almost four decades and are used along with realtime ultrasonography and umbilical artery doppler velocimetry to. Fundamentals of fetal health surveillance online manual.
Despite the extensive uptake of intrapartum fetal surveillance in the last 2030 years, particularly in the form of ctg monitoring, the hope for impact on intrapartum asphyxia has not occurred. Higherrisk mothers will be seen in hospital antenatal clinics often by doctors. Fetal heart rate monitoring affects the lives of millions of women and infants every year in the united states alone. Infomration for parents and families answering common questions about fetal monitoring in lanbour keywords fetal surveillance, fetal monitoring, ctg, cardiotocography, pinard, doppler, fetal heart rate, fetal blood sampling, cord gas queensland clinical guidelines, queensland health guidelines, qcg, qh, qld health created date. There is a mcq quiz after each module and a certificate on completion. Fetal assessment or surveillance may be provided by various means based on individual history and case presentation. Antepartum surveillance is used for women deemed to be at increased risk for fetal death. Download product flyer is to download pdf in new tab. Jan 10, 2014 antepartum fetal surveillance jason zachariah 1 slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Second, and more germane to the discussion of fetal surveillance, establishment of chorionicity is a critical component of providing ongoing fetal surveillance throughout the pregnancy because the risk for morbidity in multifetal pregnancy is directly related to problems resulting from chorionicity. Download obstetrics and gynecology pretest selfassessment. Antepartum management of the highrisk patient the previous chapter was devoted to introducing antepartum fetal surveillance, including fetal heart rate fhr testing and biophysical profile bpp. Practice bulletins authored by the american college of obstetricians and gynecologists acog are evidencebased documents that summarize current information on techniques and clinical management issues for the practice of obstetrics and gynecology the official list of current bulletins is published monthly and includes reaffirmed dates for older bulletins.
It is a recommended pre reading for our facetoface fsep sessions. Start studying intrapartum fetal surveillance ch 17. Intrapartum fetal surveillance ch 17 flashcards quizlet. Fetal surveillance aim of program the aim of the program is to provide midwives and doctors with the skills necessary to monitor, interpret and act on cardiotocograph recordings in pregnancy and labour. Program structure the program consists of a half day workshop. Checklist for antepartum care of pregestational type 1 or type 2 diabetes. Antenatal fetal surveillance maternal health medical.
The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Electronic fetal monitoring efm is the recommended method of intrapartum fetal surveillance for highrisk pregnancies. Pdf electronic fetal monitoring efm is the recommended method of intrapartum fetal surveillance for high risk pregnancies. Antepartum evaluation of the fetus and fetal well being. Sep 12, 2017 antepartum fetal surveillance aims to decrease perinatal morbidity and mortality. This work is licensed under a creative commons attribution noncommercial no derivatives v4. The correlation between full biophysical profile and rapid biophysical profile in antepartum fetal surveillance. The content is an online version of the 2009 fundamentals of fetal health surveillance. Although this chapter focuses on fetal surveillance of the woman during labor, many of these techniques and guidelines may be used in the care of a woman with an antepartum complication. Antepartum fetal surveillance north puget sound pec. Find powerpoint presentations and slides using the power of, find free presentations research about antepartal fetal surveillance ppt. Prassan vij take on the topic antepartum fetal surveillance and make it easier to understand to download the app. Background a complex interplay of antepartum complications, suboptimal uterine perfusion, placental dysfunction, and intrapartum events can result in adverse neonatal outcome.
Fetal surveillance cannot identify every compromised fetus. Jul 12, 2015 antepartum fetal surveillance the goal of antepartum fetal surveillance is to prevent fetal death. Routine fetal heart rate monitoring in the antepartum period. Antepartum management of the highrisk patient thoracic key. View and download powerpoint presentations on antepartal fetal surveillance ppt. Intrapartum fetal surveillance test bank multiple choice 1. This checklist is a general guide for antepartum care for patients with pregestational. Program outline topics and skills to be covered in the program include. Antepartum fetal surveillance aims to decrease perinatal morbidity and mortality. Antepartum fetal surveillance learn with flashcards, games, and more for free. For more information or to order the fetal surveillance acat, call awhonn distribution at 800 3542268 or surf to the awhonn web site at awhonn group to meet about highrisk antepartum issues. A warning sign that a fetus may be at risk of compromise is maternal perception of decrease in fetal movement. Family physicians, midwives, nurses, obstetricians and studentsresidents in these disciplines.
Antepartum fetal surveillance jason zachariah 1 slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Antepartum fetal surveillance techniques based on assessment of fetal heart rate fhr patterns have been in clinical use for almost four decades and are used along with realtime ultrasonography and umbilical artery doppler velocimetry to evaluate fetal wellbeing. Antepartum fetal surveillance 2014 essay 8496 words. Ppt antepartum hemorrhage powerpoint presentation free. Intrapartum fetal surveillance ifs refer to online version, destroy printed copies after use page 2 of 29. The nearubiquitous use of electronic fetal monitoring has.
Surveillance tech niques such as cardiotocography, realtime ultrasonog raphy, and maternal perception of fetal movement can identify the fetus that may be. Intermittent auscultation fetal monitoring during labour plos. Measurements frequently used to estimate gestational age and fetal biometry measurements used in assessing fetal weight, growth, and body proportions measurements for amniotic fluid assessment fetal doppler assessment noncardiac doppler of the middle cerebral artery to assess fetal anemia fetal cardiac measurements and doppler. Also intrapartum fetal surveillance medicine medical. Jan 11, 2016 chapter 6 antepartum fetal surveillance.
Nov 21, 2012 also intrapartum fetal surveillance free download as powerpoint presentation. Contraction stress test versus nonstress test for primary surveillance. Registered nurse initiated activities decision support tool no. In essence, you are free to copy and communicate the work in its current form for noncommercial purposes, as long as you attribute the queensland clinical guidelines, queensland health and abide by the licence terms. A selflearning manual produced by the canadian perinatal programs coalition and is based on the 2007 society of obstetricians and gynecologists fetal health surveillance. Pdf the correlation between full biophysical profile and. Pdf antepartal and intrapartal fetal monitoring download. Prassan vij discusses antepartum fetal surveillance. Acog pb145 antepatum fetal surveillance flashcards quizlet. Perform a transvaginal ultrasound scan on all women in whom a lowlying placenta is suspected from their transabdominal anomaly. Antepartum fetal surveillance techniques based on assessment of fetal heart rate fhr patterns have been in clinical use for almost four decades and are used. Techniques for assessment of fetal wellbeing nonstress test, contraction stress test, biophysical profile, modified biophysical profile are described in. The controversy in the medical literature that suggests that we are in an era fraught with both medical and legal dilemmas in the use of efm is explored. The main techniques for fetal assessment are the nonstress test, biophysical profile, modified biophysical profile, contraction stress test, and fetal movement count.
Petrie many changes have occured in obstetrics during the past decade and a half. A prospective study of fetal movement counting in lowrisk women noted a fetal mortality rate of 8. Antepartum fetal surveillance techniques are routinely used to assess the risk. English summery ane cecilie nordentoft midwife anne gjesing, anne cathrine hoffgaard munk, annekatrine bertelsen, carsten henriques, charlotte brix andersson project manager diana riknagel midwife, hanne brix westergaard, helle larsen, kirsten schiott, kristina renault. Ppt intrapartum fetal monitoring powerpoint presentation. Learn fetal surveillance with free interactive flashcards. A prospective multiinstitutional study of antepartum fetal heart rate monitoring. The role of the nurse expert, the standard of care, and case studies are presented that demonstrate the need for obstetric nurses to be competent in efm. Intermittent auscultation versus continuous fetal monitoring. Antepartum fetal surveillance robin petersen, msn, rn uwvalley medical center renton, washington objectives identify current indications for antepartum fetal surveillance describe antepartum fetal surveillance techniques used to assess fetal wellbeing antepartum fetal surveillance when should it start. We have just completed our second year as a formal committee and continue to meet regularly. This oer repository is a collection of free resources provided by equella.
Program structure the program consists of one full day workshop. Callens ultrasonography in obstetrics and gynecology. This is a learning in 10 voice annotated presentation vap on intrapartum fetal monitoring to learn more about learning in 10 lit, please visit. All require access to antenatal testing facilities. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The lowrisk mother will be seen largely by the midwife in community antenatal clinics. Assessment of amniotic fluid volume independent of the biophysical profile and modified biophysical profile and doppler velocimetry of fetal and funic vessels provide additional. Choose from 287 different sets of fetal surveillance flashcards on quizlet. Acog guidelines on antepartum fetal surveillance practice. This guideline provides new recommendations pertaining to the application and documentation of fetal surveillance in the antepartum and intrapartum period that will decrease the incidence of birth. At, we take user experience very seriously and thus always strive to improve. Consideration has been given to all methods of fetal surveillance currently available in canada.
While ama has clearly been shown to be a significant risk factor for stillbirth at term, in the absence of other coindications eg, maternal or fetal complications, it has not routinely served as an indication for antepartum testing. The goal of antepartum fetal surveillance is to prevent fetal death. The issue of obstetric litigation and electronic fetal monitoring efm is revisited. A certificate of completion,which details your learning history, is available in pdf format for you to download or print out. Reengineering electronic fetal monitoring interpretation. Antepartum fetal surveillance in the 1980s antepartum fetal surveillance in the 1980s petrie, roy h. In essence, you are free to copy and communicate the. It is important to stress that fetal monitoring is only part of the overall clinical assessment of both mother and fetus, aimed mainly at the detection of fetal hypoxia. Article information, pdf download for reengineering electronic fetal. Registered users can save articles, searches, and manage email alerts. This guideline is intended for use by all health professionals who provide antepartum and intrapartum care in canada. Antenatal testing may include contraction stress tests, nonstress tests, biophysical profiles, and modified biophysical profiles.
Acog practice bulletin, antepartum fetal surveillance. Checklist for antepartum care of pregestational type 1. Baseline bradycardia variability baseline or beat to beat variability is controlled by the balance between the sympathetic and parasympathetic nervous. If you continue browsing the site, you agree to the use of cookies on this website. Antepartum fetal testing is indicated in pregnancies in which the risk of antepartum fetal demise is increased. Fetal surveillance update aim of program the aim of the program is to provide midwives and doctors with revision of the skills necessary to monitor, interpret and act on cardiotocograph recordings in pregnancy and labor. The aim of fetal surveillance in labour is to identify hypoxia and allow intervention to prevent the sequelae of asphyxia. Its the health care providers responsibility to understand the method of surveillance, the frequency and indication for surveillance and the ability to interpret. Ppt antepartum fetal monitoring reinaldo figueroa, md. Antenatal care should be appropriate and effective. The aim of this study was to assess the efficiency of. Further information on the fetal surveillance education program can be found at.
Intrapartum fetal surveillance case based learning. Antenatal fetal surveillance is a field of increasing importance in modern obstetrics, especially as results in perinatal care have recently made dramatic progress. This guideline is intended for healthcare professionals, particularly those in training, who are working in hse. Antenatal fetal surveillance free download as powerpoint presentation. Fetal surveillance in multifetal pregnancy sciencedirect. Many different technologies aimed at reducing perinatal morbidity and mortality have been. The argument in favor of antepartum surveillance starting at 37 weeks is that the risk of stillbirth at this gestational age is similar in frequency to other highrisk condition for which testing is routinely performed chronic hypertension, diabetes, cholestasis, etc. The appropriate application of these methods in various clinical situations is critically important. Antepartum fetal monitoring reinaldo figueroa, md winthropuniversity hospital antepartum fetal monitoring two thirds of fetal deaths occur before the onset of labor.