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, O2, c-section if not corrected.