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FHR Tracing Exercise

PQCNC RPC Learning Session


March 3, 2020
Our Plan For This Session
• Look at the FHR tracing and the vignette that goes with each
• Describe the FHR tracing
• Contractions
• Baseline FHR
• Variability
• Periodic Changes
• Make an assessment
• What interventions, if any, would you would do next?
What Interventions Do We Have To Effect a
FHR Tracing?
Patient is a G6 P2032 at 41 weeks gestation.
She has a history of diet-controlled gestational diabetes (A1)
A fetal scalp electrode and intrauterine pressure catheter are in place.
AROM was performed 4 hours ago with particulate meconium.
Vaginal exam: 6 / 90% / -2 / Vertex
Pt is G6 P2032 at 41 weeks gestation, admitted in active labor.
Membranes have been ruptured for 12 hours.
Cervical exam: 8/ 100% / 0.
Has fetal scalp electrode and intrauterine pressure catheter.
A G1 P0 is admitted in labor at 40 weeks. She has an unremarkable prenatal history.
Membranes are intact and she has been in active labor for 3 hours with an epidural
for anesthesia.
Cervical exam is 5 / 100% / +1.
A G1 P0 was admitted at 42 weeks for post-dates induction of labor after an
uncomplicated prenatal course. The induction was started 17 hours ago.
SROM occurred 14 hours ago where scant thick particulate meconium was seen.
An IUPC and scalp electrode have been placed. Received Nubain 2 hours ago for pain
control.
Cervix is now 8 / 100% / +1.
G1 P0 at 40 weeks by uncertain LMP. The patient had no prenatal care. Medical history is notable for
insulin-dependent diabetes for 22 years. She admits she has been poorly compliant with her diabetic
management. Spontaneous onset of labor started 2 hours prior to admission. Membranes are intact.
Exam 3-4 / 90% / -1. Vertex presentation .
G1 P0 at 38 weeks gestation admitted for induction for gestational diabetes
managed by diet.
Induction of labor began 20 hours ago and AROM performed 13 hours ago with clear
fluid. The patient has an epidural in place.
Cervix is C/ C/ -2 with occiput posterior presentation.