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Electronic Fetal Monitoring (EFM)

Fetal Heart Rate (FHR)
Baseline
HR between contractions.
Normal
120–160 BPM (can be higher for short periods of time, less than 10 minutes).
Tachycardia
Sustained FHR >160 for more than 10 minutes.
Common etiology can include early fetal hypoxia, immaturity, amnionitis, maternal fever, and terbutaline (Brethaire).
Bradycardia
Sustained FHR <120 for more than 10 minutes.
Common etiology can include late or profound fetal hypoxia, maternal hypotension, prolonged umbilical cord compression, and anesthetics.

Variability (Cardiac Rhythm Irregularities)
Absent
0–2 variations per minute (abnormal)
Minimal
3–5 variations per minute (abnormal)
Moderate
6–25 variations per minute (normal)
Marked
More than 25 variations per minute (abnormal)

Deceleration (Decrease in Fetal Heart Rate)

Etiology
Management
Early Decelerations
Mirror image of
the contraction
starting and
stopping with
contractions.
Head compression
Observation
Late Decelerations
Reverse mirror image
of the contractions,
starting after contraction
starts and
ending after contraction
has ended.
Uteroplacental
insufficiency
Lateral position,
stop or slow
pitocin, O2, IV
fluids, c-section
if not corrected.
Variable Deceleration
Pattern
Occurs at unpredictable
times during contractions
and has varying shape
and size.
Cord
compression
Lateral, kneeto-
chest position, O2c-section if not corrected.

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