Fetal Heart Rate Assessment

Fetal heart rate (FHR) assessment evaluates the fetal condition by identifying FHR patterns that may be associated with adverse fetal or neonatal outcome or are reassuring of fetal well-being.

I. Fetal monitoring techniques A. Electronic fetal monitoring. The electronic fetal monitor determines the FHR and continuously records it in graphical form.

B. External fetal monitoring. The FHR is measured by focusing an ultrasound beam on the fetal heart. The fetal monitor interprets Doppler signals.

C. Internal fetal monitoring of FHR is an invasive procedure. A spiral electrode is inserted transcervically into the fetal scalp. The internal electrode detects the fetal (ECG) and calculates the fetal heart rate based upon the interval between R waves. This signal provides accurate measurement of beat-to-beat and baseline variability.

D. Biophysical profile. The biophysical profile (BPP) consists of electronic fetal heart rate evaluation combined with sonographically assessed fetal breathing movements, motor movement, gross fetal tone, and amniotic fluid volume.

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