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Pulmonary Problems in Pregnancy pp 89–105Cite as

Monitoring Fetal Well-Being in the Critical Care Setting

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Part of the book series: Respiratory Medicine ((RM))

Pregnant patients constitute a small percentage of patients in the critical care setting, but when these patients do arrive in the unit, many questions emerge regarding the need for, extent of, and interpretation of the monitoring of the fetus. Appreciating fetal heart tracings begins with an academic understanding of the terminology used for descriptions, but then requires years of experience to develop the skill in the art of interpretation. Critical care physicians cannot be expected to have a comprehensive command of the skill set needed for this task. Pregnant patients in the critical care setting therefore require an interdisciplinary approach with the participation of an obstetrician on the team, particularly if the gestational age of the fetus is beyond the limits of viability.

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References

  1. National Institute of Child Health and Human Development Research Planning Workshop. Electronic fetal heart rate monitoring: research guidelines for interpretation. Am J Obstet Gynecol 1997;177(6):1385–90.

    Google Scholar 

  2. ACOG Practice Bulletin 70: Intrapartum Fetal Heart Rate Monitoring. Obstet Gynecol 2005;106:1453–60.

    Google Scholar 

  3. Alfirevic Z, Devane D, Gyte GM. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev 2006;19:3.

    Google Scholar 

  4. Nelson KB, Dambrosia JM, Ting TY, Grether JK. Uncertain value of electronic fetal monitoring in predicting cerebral palsy. N Engl J Med 1996;324:613–8.

    Article  Google Scholar 

  5. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: final data for 2003. Natl Vital Stat Rep 2005;54(2):1–116.

    Google Scholar 

  6. Clark SL, Hankins GD. Temporal and demographic trends in cerebral palsy--fact and fiction. Am J Obstet Gynecol 2003;188(3):628–33.

    Article  PubMed  Google Scholar 

  7. Devane D, Lalor J. Midwives' visual interpretation of intrapartum cardiotocographs: intra- and inter-observer agreement. J Adv Nurs 2005;52(2):133–41.

    Article  PubMed  Google Scholar 

  8. Ayres-de-Campos D, Bernardes J, Costa-Pereira A. Pereira-Leite L. Inconsistencies in classification by experts of cardiotocograms and subsequent clinical decision. Br J Obstet Gynaecol 1999;106(12):1307–10.

    Article  PubMed  CAS  Google Scholar 

  9. Creasy RK, Resnick R, Iams JD, eds. Maternal-Fetal Medicine: Principles and Practice. 5th ed. Philadelphia: WB Saunders, 2004:335–6.

    Google Scholar 

  10. Dawes GS, Moulden M, Redman CW. Short-term fetal heart rate variation, decelerations, and umbilical flow velocity waveforms before labor. Obstet Gynecol 1992; 80:673–678

    PubMed  CAS  Google Scholar 

  11. Williams Obstetrics. 21st ed. New York: McGraw-Hill Professional; 2001:340.

    Google Scholar 

  12. Low JA, Pancham SR, Piercy WN, Worthington D, Karchmar J. Intrapartum fetal asphyxia: clinical characteristics, diagnosis, and significance in relation to pattern of development. Am J Obstet Gynecol 1977;129:857–72.

    PubMed  CAS  Google Scholar 

  13. Paul WM, Quilligan EJ, MacLachlan T. Cardiovascular phenomena associated with fetal head compression. Am J Obstet Gynecol 1964;90:824.

    PubMed  CAS  Google Scholar 

  14. Williams Obstetrics. 21st ed. New York: McGraw-Hill Professional; 2001:345.

    Google Scholar 

  15. Petrie RH: Dose/response effects of intravenous meperidine in fetal heart rate variability. J Matern Fetal Med 1993;2:215.

    Article  Google Scholar 

  16. Hallak M, Martinez-Poyer J, Kruger ML, Hassan S. Blackwell SC, Sorokin Y. The effect of magnesium sulfate on fetal heart rate paramenters: A randomized, placebo-controlled trial. Am J Obstet Gynecol 1999;181:1122.

    Article  PubMed  CAS  Google Scholar 

  17. Morrison I, Menticoglou S, Manning FA, et al.: Comparison of antepartum test results to perinatal outcome. J Matern Fetal Med 1994;3:75.

    Article  Google Scholar 

  18. East CE, Smyth R, Leader LR, Henshall NE, Colditz PB, Tan KH. Vibroacoustic stimulation for fetal assessment in labour in the presence of a nonreassuring fetal heart rate trace. Cochrane Database Syst Rev. 2005 Apr 18;(2).

    Google Scholar 

  19. Creasy RK, Resnick R, Iams JD, (Eds). Maternal-Fetal Medicine: Principles and Practice. 5th ed. Philadelphia: WB Saunders, 2004:432.

    Google Scholar 

  20. Manning FA, Snijders R, Harman CR, et al. Fetal biophysical profile scoring. VI. Correlations with antepartum umbilical venous pH. Am J Obstet Gynecol 1993;169:755.

    PubMed  CAS  Google Scholar 

  21. Manning FA. Fetal Biophysical Profile. Obstet Gynecol Clin North Am 1999;26:557–77.

    Article  PubMed  CAS  Google Scholar 

  22. Dayal AK,Manning FA, Berck DJ, Mussalli GM, Avila C, Harman CR, Menticoglou S. Fetal death after normal biophysical profile score: An eighteen-year experience. Am J Obstet Gynecol 1999;18(5):1231–6.

    Article  Google Scholar 

  23. Katz V, Balderston K, DeFreest M. Perimortem cesarean delivery: were our assumptions correct? Am J Obstet Gynecol 2005;192(6):1916–20; discussion 1920–1.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. OB/Gyn Resident, Brown University/Women & Infants Hospital, 101 Dudley Street, Providence, RI 02905, USA

    Kristen Cotter MD, MPH

  2. Professor of Obstetrics and Gynecology, Mount Sinai Hospital, 600 University Avenue – Room 1007, Toronto, ON M5G 1X5, Canada

    Mathew Sermer MD, FRCSC

Authors
  1. Kristen Cotter MD, MPH
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  2. Mathew Sermer MD, FRCSC
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    © 2009 Humana Press, a part of Springer Science+Business Media, LLC

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    Cotter, K., Sermer, M. (2009). Monitoring Fetal Well-Being in the Critical Care Setting. In: Rosene-Montella, K., Bourjeily, G. (eds) Pulmonary Problems in Pregnancy. Respiratory Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-445-2_7

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    • DOI: https://doi.org/10.1007/978-1-59745-445-2_7

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    • Publisher Name: Humana Press

    • Print ISBN: 978-1-934115-12-1

    • Online ISBN: 978-1-59745-445-2

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