On this Learning Station, you can read and test your knowledge. Tap on a book to open its chapter list. In each chapter, you can take a quiz to test your knowledge.
To take tests, you must register with your email address or cell number. It is free to register and to take tests.
For help email firstname.lastname@example.org or call +27 76 657 0353.
Learning is easiest with printed books. To order printed books, email email@example.com or call +27 76 657 0353.
Visit bettercare.co.za for information.
A normal fetal heart rate pattern is reassuring as it suggests that the fetal condition is good. Fetal distress is very unlikely if the fetal heart rate pattern is normal.
A baseline fetal heart rate (between contractions) of more than 160 beats per minute.
A baseline fetal heart rate (between contractions) of less than 110 beats per minute.
A baseline fetal heart rate of less than 110 beats per minute must be distinguished from the maternal heart rate. If the mother is asked to take a deep breath and then bear down as in delivery her heart rate, but not that of her fetus, will slow.
A baseline bradycardia of less than 110 beats per minute usually indicates fetal distress which is caused by severe fetal hypoxia. If late decelerations are also present, a baseline bradycardia indicates that the fetus is at great risk of dying.
Early decelerations are characterised by a slowing of the fetal heart rate starting at the beginning of the contraction, and returning to the baseline by the end of the contraction. Therefore the fetal heart rate during an early deceleration is slowest during the middle of the contraction. Early decelerations are usually due to compression of the fetal head during contractions. This causes the heart rate to slow during the contraction only.
Early decelerations only occur during the middle of a contraction.
Early decelerations do not indicate the presence of fetal distress. However they may indicate very strong contractions. Therefore, these fetuses must be carefully monitored as they are at an increased risk of fetal distress.
A late deceleration is a slowing of the fetal heart rate during a contraction, with the rate only returning to the baseline 30 seconds or more after the contraction has ended. They are present with every contraction.
Late decerations continue after the end of the contraction.
Repeated late decelerations are a sign of fetal distress and are caused by fetal hypoxia. The degree to which the heart rate slows is not important. The timing of the deceleration is what must be carefully observed. Late decelerations must always be taken seriously.
Repeated late decelerations indicate fetal distress.
Variable decelerations have no fixed time relationship to uterine contractions. Therefore, the pattern of decelerations changes from one contraction to another. Variable decelerations are usually caused by compression of the umbilical cord and do not indicate the presence of fetal distress. However, these fetuses must be carefully monitored as they are at an increased risk of fetal distress.
Variable decelerations are not easy to identify when a fetal monitor is used.
These fetal heart rate patterns do not indicate fetal distress but warn that the woman should be closely observed as there is an increased risk that fetal distress may develop. If electronic monitoring is available, all these high risk fetuses should be monitored continuously by CTG.
The fetal heart rate must be assessed before, during and after a contraction. The following questions must be answered and recorded on the partogram:
Early decelerations occurring while the mother is pushing are common and do not necessarily indicate fetal distress. However, the baseline rate should benormal. A baseline bradycardia between contractions and before the mother pushes suggests fetal distress and is an indication for urgent delivery. The fetal heart rate should be normal before and after each bout of pushing.