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Tuesday, January 26, 2010

Review of Three-Tier Fetal Heart Rate Interpretation System

Category I : Normal.
The fetal heart rate tracing shows ALL of the following:

Baseline FHR 110-160 BPM, moderate FHR variability, accelerations may be present or absent, no late or variable decelerations, may have early decelerations.

Strongly predictive of normal acid-base status at the time of observation. Routine care.

Category II : Indeterminate.

The fetal heart rate tracing shows ANY of the following:

Tachycardia, bradycardia without absent variability, minimal variability, absent variability without recurrent decelerations, marked variability, absence of accelerations after stimulation, recurrent variable decelerations with minimal or moderate variability, prolonged deceleration > 2minute but less than 10 minutes, recurrent late decelerations with moderate variability, variable decelerations with other characteristics such as slow return to baseline, and "overshoot".

Not predictive of abnormal fetal acid-base status, but requires continued surveillance and reevaluation.

Category III: Abnormal.

The fetal heart rate tracing shows EITHER of the following:

Sinusoidal pattern OR absent variability with recurrent late decelerations, recurrent variable decelerations, or bradycardia.

Predictive of abnormal fetal-acid base status at the time of observation. Depending on the clinical situation, efforts to expeditiously resolve the underlying cause of the abnormal fetal heart rate pattern should be made.


Case 1
G1P0 . Induction for preeclampsia at 37 weeks.



Case 2
G2P1. Arrived in active labor at 40 weeks


Case 3
G1, P0, 34 weeks gestation admitted to Labor and Delivery with SROM with moderate amount of pink tinged fluid.



Macones GA et al., The 2008 National Institute of Child Health and Human Development Workshop Report on Electronic Fetal MonitoringUpdate on Definitions, Interpretation, and Research Guidelines Obstetrics & Gynecology 2008;112:661-666 PMID:18757666

1 Comments:

Blogger Peri1 said...

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February 4, 2014 at 8:11 PM  

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