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Fetal Heart Tones

This document describes fetal heart tones, including conditions that can cause fetal tachycardia or bradycardia and their grading. It also discusses variability, accelerations and decelerations including early decelerations caused by uterine squeeze, late decelerations caused by uteroplacental insufficiency, and variable decelerations which may indicate cord compression. Nursing interventions are provided for different fetal heart tone patterns.

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Christian Clyde N. Jakosalem
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99 views

Fetal Heart Tones

This document describes fetal heart tones, including conditions that can cause fetal tachycardia or bradycardia and their grading. It also discusses variability, accelerations and decelerations including early decelerations caused by uterine squeeze, late decelerations caused by uteroplacental insufficiency, and variable decelerations which may indicate cord compression. Nursing interventions are provided for different fetal heart tone patterns.

Uploaded by

Christian Clyde N. Jakosalem
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FETAL HEART TONES

CONDITION CAUSE GRADE

Fetal Tachycardia ❖ Infection ❖ Mild : > 5 BPM from baseline


❖ Dehydration ❖ Moderate: 6-25 BPM from baseline
❖ Fever ❖ Severe: < 25 BPM from baseline
❖ Fetal hypoxemia ❖ Absent : No fluctuation in fetal heart rate
❖ Anemia
❖ Prematurity
❖ Terbutaline
❖ Caffeine
❖ Epinephrine
❖ Theophylline
❖ illicit drugs

Fetal bradycardia ❖ Maternal hypotension ❖ Mild : > 5 BPM from baseline


❖ Supine hypotensive syndrome ❖ Moderate: 6-25 BPM from baseline
❖ Fetal decompression ❖ Severe: < 25 BPM from baseline
❖ Late fetal hypoxia ❖ Absent : No fluctuation in fetal heart rate
❖ Cord compression
❖ Abruptio placenta
❖ Vagal stimulation

Accelerations & Decelerations


Variability Accelerations: must be 15 BPM above the FHR baseline for 15
seconds 15x15 window
FHR drops from baseline then recovers, usually jagged and Decelerations : A decrease in FHR during uterine contraction ”
erratically shaped. Can happen at anytime during contraction mirrors contractions usually a U shape
Periodic changes : variations that occur during a contraction.
Nursing interventions : Left Side. IV bolus of fluids, O2 6l mask, ❖ Reassuring periodic changes : must be 15 BPM
Notify HCP above the FHR baseline for 15 seconds ( 15x15 window)
❖ Benign periodic changes: Early decelerations
A great way to remember this is L.I.O.N
Decreased or absent variability: Non reassuring, acute treatment Episodic changes: occur in association with medication
and monitoring are indicated. administration or analgesia
Decreased or absent variability: medications, narcotics, mag
Wandering baselines with no variability could indicate
sulfate ( preeclampsia, preterm), terbutaline, fetal sleep (
❖ Congenital defects normally 20 minute cycles), prematurity, fetal hypoxemia.
❖ Metabolic acidosis

Fetal decelerations
The nurse should administer 02 and the baby needs to be
delivered as quickly as possible.

Memory trick
Early decelerations : A decrease in FHR during uterine contraction mirrors
uterine contractions . caused by uterine squeeze
❖ FHR slows as the contraction begins
V: variable deceleration C: cord compression ❖ Lowest point coincides with the highest point ACME of the
E:early deceleration H: head compression contraction
A: acceleration O: ok ❖ Deceleration ends with the contraction
Late deceleration Placental insufficiency Late deceleration: occurs after the peak of contraction due to uteroplacental
insufficiency, pitocin, HTN, diabetes, placental abruption.
❖ Too many decelerations will indicate a need for C-section
❖ Prepare for fetal resuscitation
Variable decelerations: may indicate cord compression. Occur at different
times during a contraction, resulting in fetal HTN that causes the aortic arch
to slow the FHR. usually abrupt and sudden.
Measures to clarify NONreassuring FHR patterns
❖ Fetal stimulation
❖ Fetal scalp sampling
❖ Fetal scalp oximetry

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