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Fetal Monitoring Update

Fetal Monitoring Update

October 2009, New Hampshire AWHONN and the New Hampshire section of ACOG co-hosted a day-long interdisciplinary fetal monitoring program with Lisa Miller, CNM, JD and Dr. David Miller.  Fetal Surveillance: Increasing Safety and Reducing risk was a great success with 180 participants and a wide variety of disciplines represented including medicine, nursing, and midwifery.

Lisa and Dr. Miller reviewed and reinforced the 2008 update from the National Institute of Child Health and Human Development's (NICHD) workshop report on electronic fetal monitoring. 

Highlights from the  NICHD update include further definition/clarification of uterine contractions and the 3-tier fetal heart rate interpretation system.  Normal uterine contractions are five or fewer contractions in 10 minutes averaged over a 30-minute period.  Tachysystole is defined as more than five contractions in 10 minutes averaged over 30 minutes. 

The update states that the terms hyperstimulation and hypercontractility have no meaning and should be abandoned.  The update also presents a new classification system of fetal heart rate patterns.  Category I describes normal fetal heart rate tracings, Category II describes indeterminate tracings, and Category III describes abnormal fetal heart rate tracings.  The full report of the 2008 NICHD update is available www.ncbi.nlm.nih.gov/pmc/articles/PMC2621055/

The speakers also presented their second version of the Intrapartum Fetal Heart Rate Management Decision Model©.  The model provides a systematic way to interpret fetal heart monitoring data to make care decisions based on an "ABCD" assessment.  "A" refers to assessing the oxygen pathway, "B" refers to beginning corrective measures, "C" is clearing obstacles to rapid delivery, and "D" is determining decision to delivery time.

 Each conference participant received a laminated copy of the Intrapartum Fetal Heart Rate Management Decision Model© not yet available to the public. The first version of the decision model was published in Mosby's Pocket Guide to Fetal Monitoring: An Multidisciplinary Approach, a book co-authored by Lisa Miller and Dr. Miller.

Due to the overwhelming response, NH AWHONN will be inviting Lisa and Dr. Miller back in the fall of 2011.  Keep an eye out for a save-the date card coming out early 2011.

 

Page Updated 2/25/10