FHM Vignette #11: A 23-Year-Old G1P0 with IUGR At 37 Weeks

Course overview

Training on reading FHR monitor strips is often not applied to specific clinical situations or to an understanding of why the FHR patterns look as they do in those situations. This activity reviews FHR patterns and highlights useful information for practitioners who interpret fetal tracings. The basic steps in FHR monitor strip interpretation include: 1) accurate assessment of the FHR pattern using the standardized NICHD terminology; 2) accurate assessment of maternal uterine activity; 3) consideration of maternal/fetal physiology as it relates to the current clinical situation; 4) determination of the appropriate FHR category; and 5) intervention and management appropriate to tracing interpretation. After completing this activity, practitioners should be able to: recognize a Category II and Category III FHR tracing associated with IOL of a growth-restricted fetus (IUGR); list necessary EMR documentation prior to initiating IOL; identify responsibilities associated with IOL and misoprostol administration; describe the pathophysiology of a prolonged deceleration; and identify appropriate antepartum tests to assess fetal well-being of the growth-restricted fetus.