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Digital Seminar

Electronic Fetal Monitoring: A Standardized Approach

$69.99 Standard

Obstetric clinicians with their knowledge and skills, remain one of most important elements in high-quality intrapartum care. Unfortunately, after several decades of clinical use, many uncertainties continue to surround intrapartum monitoring including interpretation, management, and other related decision-making processes. When clinicians are not current in fetal monitoring or do have a firm grasp of basic concepts, there is a risk for adverse maternal and neonatal outcomes.  This can have a significant negative impact on families and the healthcare system. Therefore maternal-fetal safety is of the utmost importance.  Thus, continuous learning that includes contemporary research is fundamental for patient safety and for optimizing perinatal outcomes.  An overview of fetal monitoring principles as well as updated research will be presented in this 2-hour recorded session.

Here's What You'll Learn


 ABCD approach

  •  Assess the oxygen pathway a. Lungs, heart, vasculature, uterus, placenta, umbilical cord
  • Begin corrective measures as previously outlined
  • Clear obstacles to delivery
    • Facility
    • Staff
    • Patient
    • Fetus
    • Labor
  • Determine decision to delivery time
    • Facility response time
    • Staff
    • Surgical, medical and obstetric considerations
    • Other considerations (e.g., EFW, presentation) 

 

Terminology

  • What is it called
  • Consensus statement by NICHD
    • Adopted by AWHONN, ACOG, and ACNM
  • Interpretation
    • What does it mean
    • What information does the FHR tracing provide regarding oxygen transfer
      • Head compression, cord compression, uteroplacental dysfunction
      •  All decelerations have the exact same triggers
        • Interruption of oxygen transfer from the environment to the fetus at one or more points along the oxygen pathway
        • moderate variability and/or accelerations exclude ongoing hypoxic injury
  • Management
    • What do we do about it
    • Corrective measures
      • IV fluid bolus
      • Lateral positioning
      • Correct hypotension
      • Decrease uterine activity
      • Amnioinfusion
      • Tocolytic administration
      • Alter pushing technique
      • Oxygen administration for maternal pulse ox <96%
    • Introduction to ABCD approach to management 

ABCD approach

  • Assess the oxygen pathway
    • Lungs, heart, vasculature, uterus, placenta, umbilical cord
  • Begin corrective measures as previously outlined
  • Clear obstacles to delivery
    • Facility
    • Staff
    • Patient
    • Fetus
    • Labor
  • Determine decision to delivery time
    • Facility response time
    • Staff
    • Surgical, medical and obstetric considerations
    • Other considerations (e.g., EFW, presentation) 

“Intrapartum management of Category II FHR tracings towards standardization of care” 2013 article

  • Algorithm
  • Expert Opinions a. Not evidence based
  • Definition of Significant Decelerations
  • Key components of algorithm that are missing
    • Precise cervical dilation
    • When to notify primary clinician
      • “A standardized approach for Category II fetal heart rate with significant decelerations: Maternal and neonatal outcomes”. 2018 article
        • Prospective interventional trial: 29 hospitals
        • Comparison between 2013 expert opinion and this trial algorithm
        • Published results related to maternal and neonatal outcomes
        • Only research conducted with a research protocol 

Everything You're Getting


  • More than 1 hour of video content
  • Up to 1.75 CE credits
  • Certificate of completion
  • Handouts and resources

Meet Your Experts


Rebecca Cypher, MSN, PNNP

Toggle speaker biography

Rebecca Cypher, MSN, PNNP, is owner of Maternal-Fetal Solutions, LLC, an independent consulting and education service, where she primarily focuses on assisting clinicians and hospitals to be change agents in the delivery of obstetric care. Her professional experience expands over 30 years in the perinatal arena, with 20 years on active duty, serving as a Nurse Corps officer in the United States Air Force, which included a wide variety of inpatient and outpatient obstetric settings in clinical and management positions. After military retirement, she worked as a perinatal nurse practitioner in a maternal-fetal medicine division focusing on obstetrical care and research. Rebecca served on the Board of Directors at the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) including one term as president. Rebecca is passionate about her profession and multidisciplinary education, with her attention devoted to evidence-based practice, clinical judgment, critical thinking, and collaboration within the healthcare team.


Speaker Disclosures:
Financial: Rebecca Cypher is the owner of Cypher Maternal-Fetal Solutions, LLC; a research nurse with the Amniotic Fluid Embolism Foundation; and a medical advisor for Clinical Computer Systems, Inc. She receives royalties as a published textbook author. She also receives speaking honorarium and recording royalties from PESI, Inc. All relevant financial relationships with ineligible organizations have been mitigated.
Non-financial: Rebecca Cypher is a member of the Association of Women's Health, Obstetric and Neonatal Nurses and the Society for Maternal-Fetal Medicine. She also has a professional affiliation with the Washington State Maternal Mortality Review Panel. Rebecca Cypher is a contributing editor, editorial board member, and manuscript reviewer for the Journal of Perinatal & Neonatal Nursing, and a manuscript reviewer for Nursing for Women's Health.

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Media Type:
Digital Seminar
Product Code:
POS078548
Brochure Code:
SUM88406
Duration:
1 hour, 54 minutes
Copyright:
Jan 03, 2023
Format:
Audio and Video

ADA Needs


We would be happy to accommodate your ADA needs; please call our Customer Service Department for more information at 1-800-844-8260.

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