Fetal Monitoring Interpretation

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Author: Micki L. Cabaniss
Published: January 1993
Publisher: Lippincott Williams & Wilkins
ISBN: 0397508247
Hardcover Book
Number of Pages: 587

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Fetal Monitoring Interpretation

This is an extensive collection of sample fetal monitoring tracings and case studies from the late 1970s to the early l980s. The author systematically critiques and makes clinical interpretations. The stated purpose is to teach fetal monitoring interpretation through a pattern-oriented approach using tracings encountered in actual patient care. It includes discussion of basic physiologic mechanisms attributed to the respective monitoring patterns as well as how to distinguish artifactual patterns in labor. This textbook is written for obstetricians and obstetrics residents, but it may also serve as a reference for medical students, midwives, and nurses simply because it provides such a large variety of sample fetal heart rate tracings; anyone who works in labor and delivery may use it as a guide for comparison of tracings actually encountered. The book contains no color, but each case study includes black-and-white reproductions of fetal heart rate tracings from original monitoring strips, with separate enlarged and enhanced drawings to help with pattern recognition; they are of good quality and easy to interpret. There are extensive, reasonably up-to-date references at the end of each chapter from some of the leaders in the field. The index is acceptable but lacks easy access to key clinical concepts or scenarios that would commonly be encounte red in a l990s labor and delivery room. Some of the terminology used in categorizing certain tracings is confusing because of the author's interpretation of the pattern, but the text is otherwise well-organized and based on broad functional classifications of fetal heart rate patterns. This is a great reference for residents and students tolook up clinical correlations with particular tracing patterns, and it does help to teach pattern recognition of basic fetal heart rate tracings. However, in more complicated tracings, the author tends to overread what she interprets as pertinent components of a tracing that in the long run are not clinically relevant, as seen in the case outcomes. Teaches fetal monitoring interpretation through a pattern-oriented approach. A classification of interpretations is introduced that is based on the type of clinical management that may be prompted by the pattern. The fetal heart rate patterns are organized in a standard fashion, beginning with baseline findings and followed by periodic and nonperiodic changes from the baseline. Uterine activity and superimposed maternal/fetal movement are presented in a separate section, while dual monitoring and other multiple baselines are presented together to enhance recognition of artifactual heart rate traces. Although dysrhythmias are presented throughout the volume, the separate section on dysrhythmias enables further study of these unique fetal monitoring heart rate traces accompanied by electrocardiograms and echocardiograms. For physicians, residents, nurses, and students. Cabaniss, Micki L., MD (Univ of North Carolina at Chapel Hill)One of the contributors is a consultant cardiologist from North Carolina, and the other is the former director for the Center for Women and Children Mobile Infirmary, Mobile, Alabama.

Table of Contents
Sect. I Use and Limitations of the Fetal Monitor 1
1 Functional Classification of Fetal Monitoring Patterns 5
2 Limitations of Fetal Monitoring 15
Sect. II Baseline Information 27
3 Bradycardia 29
4 Tachycardia 51
5 Increased Variability - Saltatory Pattern 69
6 Decreased Variability 89
7 Sinusoidal and Other Undulating Patterns 119
8 Baseline Shifts and Other Baseline Changes 147
Sect. III Periodic and Nonperiodic Changes 173
9 Accelerations 175
10 Uniform Decelerations: Early Decelerations 205
11 Uniform Decelerations: Late Decelerations 213
12 Variable Decelerations 231
13 Late/Variable Decelerations 297
14 Prolonged Decelerations 311
Sect. IV Uterine/Maternal/Fetal Activity 333
15 Uterine Activity 335
16 Maternal/Fetal Activity 383
Sect. V Dual Monitoring and Other Multiple Baselines 401
17 Dual Channel Monitoring 403
18 Single Channel Monitoring with Multiple Heart Rates 425
19 Remote Transmission 445
Sect. VI Dysrhythmias 451
20 Sinus Node Variants 453
21 Supraventricular Dysrhythmias 471
22 Ventricular Dysrhythmias 497
23 Atrioventricular Block 511
24 Dysrhythmias Masked by Instrument Characteristics 521
25 Artifacts 535
Index 551

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