Öz
Abstract
Evaluation of the fetal heart rate (FHR) for obtaining essential information is required for fetal risk assessment during labor and birth and it is helpful for the detection of potential harmful effects on fetal systems and for allowing timely and effective interventions to prevent perinatal/neonatal morbidity or mortality. Electronic FHR monitoring (EFM) is the most widely used method of intrapartum surveillance of fetal well-being. The most apparent problem with the use of EFM in maternity wards is the wide variability with which obstetricians interpret and respond to its findings in labor ward settings. There are many FHR patterns that lie between the completely reassuring patterns and those considered ominous. ACOG's Practice Bulletin 116 recommends the use of the three-tier classification system for FHR tracings. Category 1 FHR tracings are considered normal and no specific action is required. Category 2 tracings are considered indeterminate. This category requires evaluation and surveillance and possibly other tests to ensure fetal well-being. Category 3 tracings are considered abnormal and require prompt evaluation.
Key words: Electronic fetal monitoring, fetal heart rate, intrapartum
ÖzetDoğum eylemi ve doğum sırasında fetal risk durumu hakkında değerli bilgiler elde etmek için fetal kalp hızının (FKH) değerlendirmesi gerekir ve bu değerlendirme fetal sistemler üzerine olası zararlı etkilerin saptanmasına ve perinatal/neotanatal morbidite ve mortalitenin önlenmesi için zamanında ve etkin önlemlerin alınmasında yardımcı olur. Elektronik fetal kalp hızı monitorizasyonu (EFM), intrapartum fetal iyilik halinin izlenmesinde en sık kullanılan yöntemdir. Doğumhanelerde EFM kullanımı ile ilişkili en belirgin sorun, doğum hekimlerinin doğumhane koşullarında EFM bulgularını değerlendirmesinin ve bunlara karşı yaptıkları girişimlerin çok farklı olabilmesidir. Çok sayıda FKH paterni tamamen sağlıklı olanlarla tehlikeli olanların arasında bulunur. ACOG Pratik Bülteni 116 FKH traseleri için üç aşamalı sınıflama sistemini önermektedir. Kategori 1 FKH traseleri normal kabul edilir ve özellikli bir önlem gerekmez. Kategori 2 traseleri arada kabul edilir. Bu kategori değerlendirme ve izleme gerektirir ve fetal iyilik halini gösteren diğer testlere ihtiyaç olabilir. Kategori 3 traseleri anormal kabul edilir ve hemen değerlendirme gerektirir.
Anahtar sözcükler: Elektronik fetal monitorizasyon, fetal kalp hızı, intrapartum
Anahtar Kelimeler
Kaynakça
- Hankins GD, Miller DA. A Review of the 2008 NICHD Research Planning Workshop: Recommendations for Fetal Heart Rate Terminology and Interpretation. Clin Obstet Gynecol. 2011 Mar;54(1):3-7.
- Pettker CM. Standardization of intrapartum management and impact on adverse outcomes. Clin Obstet Gynecol. 2011 Mar;54(1):8-15.
- American College of Obstetricians and Gynecologists. Practice bulletin no. 116: Management of intrapartum fetal heart rate tracings. Obstet Gynecol. 2010 Nov;116(5):1232-40.
- Robinson B, Nelson L. A Review of the Proceedings from the 2008 NICHD Workshop on Standardized Nomenclature for Cardiotocography: Update on Definitions, Interpretative Systems With Management Strategies, and Research Priorities in Relation to Intrapartum Electronic Fetal Monitoring. Rev Obstet Gynecol. 2008 Fall;1(4):186-92.
- Graham EM, Petersen SM, Christo DK, Fox HE. Intrapartum electronic fetal heart rate monitoring and the prevention of perinatal brain injury. Obstet Gynecol. 2006 Sep;108(3 Pt 1):656-66.
- Farley D, Dudley DJ. Fetal assessment during pregnancy. Pediatr Clin North Am. 2009 Jun;56(3):489-504.
- Macones GA, Hankins GD, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol. 2008 Sep;112(3):661-6.
- American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol. 2009 Jul;114(1):192-202.
Öz
Kaynakça
- Hankins GD, Miller DA. A Review of the 2008 NICHD Research Planning Workshop: Recommendations for Fetal Heart Rate Terminology and Interpretation. Clin Obstet Gynecol. 2011 Mar;54(1):3-7.
- Pettker CM. Standardization of intrapartum management and impact on adverse outcomes. Clin Obstet Gynecol. 2011 Mar;54(1):8-15.
- American College of Obstetricians and Gynecologists. Practice bulletin no. 116: Management of intrapartum fetal heart rate tracings. Obstet Gynecol. 2010 Nov;116(5):1232-40.
- Robinson B, Nelson L. A Review of the Proceedings from the 2008 NICHD Workshop on Standardized Nomenclature for Cardiotocography: Update on Definitions, Interpretative Systems With Management Strategies, and Research Priorities in Relation to Intrapartum Electronic Fetal Monitoring. Rev Obstet Gynecol. 2008 Fall;1(4):186-92.
- Graham EM, Petersen SM, Christo DK, Fox HE. Intrapartum electronic fetal heart rate monitoring and the prevention of perinatal brain injury. Obstet Gynecol. 2006 Sep;108(3 Pt 1):656-66.
- Farley D, Dudley DJ. Fetal assessment during pregnancy. Pediatr Clin North Am. 2009 Jun;56(3):489-504.
- Macones GA, Hankins GD, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol. 2008 Sep;112(3):661-6.
- American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol. 2009 Jul;114(1):192-202.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Clinical Sciences |
| Yazarlar | |
| Yayımlanma Tarihi | 5 Nisan 2013 |
| Yayımlandığı Sayı | Yıl 2010 Cilt: 1 Sayı: 4 |