Fetal Heart Rate Research Paper

Key words: high reliability, electronic fetal monitor (EFM), category II fetal heart rate (FHR)

Huddle Up for Fetal Safety: Strategies to Improve Outcomes In the mid-1990s, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) sponsored a series of workshops to standardize definitions of electronic fetal monitoring (EFM) fetal heart rate (FHR) characteristics. The common language they developed to describe fetal heart rate tracing patterns, which provide important information on the acid-base status of the fetus at the current point in time, was widely adopted by professional women's health organizations in the United States. Thereafter, in 2008, the NICHD, American College of Obstetricians and Gynecologists (ACOG), and the
Category II FHR tracings are indeterminate, not reflective of abnormal acid-base status, but requiring continued evaluation, surveillance, and reevaluation, with increased risk for fetal hypoxia/ acidemia (Macones et al., 2008). [Table 1: 3-Tier FHR Interpretation System] Category II FHR tracings are less clearly defined than Category I and III and can be challenging to manage, as they make up a large category with many combinations of features. Although Category II FHR tracings sometimes develop into Category III, they are not often indicative of fetal complications that result in bad outcomes, making it easy for all members of the surveillance team to become complacent (Cahill, Roehl, Odibo, & Macones, 2012). During labor, 84% of FHR tracings exhibit category II features (Jackson, Holmgren, Esplin, Henry, & Warner, 2011) and in the last 30 minutes of second stage, 97% of FHR tracings are Category II (Cahil et al., 2012). In collaboration with obstetric (OB) residents, certified nurse-midwives (CNMs), and physician providers, RNs