● Doppler

● Fetoscope
● Stethoscope

● Intermittent - during pre-natal visits/check up

○ Check FHR of the baby
■ If not visible the FHR, baby is distress

● Doppler - just press the button then apply gel, first perform the manuever

● Doppler - 12 weeks or 3rd months

● Fetoscope - 16 weeks or 4th months
● Stetoscope - 20 weeks or 5th months

● Kapag sa lying in, ilalagay ung doppler kay maam

● Kapag no resistant, refer the mother to the hospital
● Kapag walang instrument, refer to bigger hospital

● Kapag clear and loud, heart rate ni baby

● Pero kapag mabagal or mahina, possible heart rate ni mother

● Kapag may ganyang symptoms, nag associate sa baby kaya nag cocompensate nag lelead sa
tachycardia
● Maternal hyperthyroidism -

● Accelerations -
● Beta blockers
○ - ending with olol
○ decreases the blood pressure
○ Baka si mommy may iniinom na mga beta blockers

● Cord compression
○ Impair circulation of blood flow
○ Impaired gas exchange

● Bradyarrhythmia
○ Heart does not develop well
● Cardiotocography (CTG) is a technique used to monitor the fetal heartbeat and the uterine
contractions during pregnancy and labour.
○ Cardio - fhr
○ Tocho - uterine contraction of the mother

● 2 types of tranduser
○ Toco tranduser - no need to apply gel
○ Cardio transduser - need gel - para mas madali masense ung FHR
● Leopolds muna tas ilalagay mo na ung cardio tas sa kabila ung tocho

● Administer oxytocin to the IV fluid - para the baby will go to vaginal canal
○ No fast drip - cause cardiac arrest

● Transducer nakapasok sa loob directly to the fetal skin (scalp or body part)
● Prone for infection - di sya gaano ginagamit

● Need to check maternal heart rate para malaman kung sa mother or kay baby
● Hindi need ng contraction dito kasi Fetal movement lang chinecheck
● Press the button if you feel the baby is moving inside the womb
○ Looking for the reaction: fetal heart rate acceleration
○ Acceleration - heart rate increase in the fetal movement
● Kapag NST, hinahanap lang ung heart rate pag may fetal movement
● Reactive - Normal - 2 FHR accelerations
● Nonreactive - abnormal > cause: baby is sleeping, or cns depression
○ Management:
■ Receive snack/ acoustic vibration (patugtog ka)
■ Repeat the test
■ Refer if its still nonreactive
● Do nipple stimulation para magkaroon din ng uterine contraction
● Decelerations - pagbaba ng heart rate ni baby
● Accelerations - pag taas ng heart rate
● Stay in facility for 30 mins to monitor the conraction kasi baka mag tuloy tuloy baka mag
preterm labor

● Placenta previa - more bleeding

● PROM - hindi pa ang labor nag rupture na ung membrane
● Cervical incompetence - nagdidilate ung cervix kahit di pa nag lalabor
○ Prone to abortion
○ Management: Cervical cerclage - stitch the cervix
● Multiple gestation - labor is faster
● Ask to void
○ Para hindi distended ung bladder para walang hindrance sa kanyang pag contract
○ kasi invasive sya
○ Promote comfort
○ Para di sya maihi during procedure
● Accelerations = well fetal being
● Due to head compression during active labor or baby is about to go in the passage way
● The deceleration happens during the peak of the contraction
● Placenta is not well developed
● We need to stop the oxytocin bec there is placenta insufficiency magkakaroon ng abruptio
palcenta - theres early
● Knee chest -
● Moist the gauze - to prevent drying
● Pag fully dilated na baby - pwede na mag nsd
● Pero kapag hindi pa dilated -
● Non reassuring - candidate for CS