Fetal heart rate monitoring affects the lives of millions of women and infants every year in the United States alone. Used by all members of the obstetric team - nurses, students, midwives, and physicians - it is the primary method to assess fetal oxygenation in both the antepartum and intrapartum setting. Improving outcomes and promoting patient safety depends upon correct use and interpretation of fetal heart rate monitoring, and is crucial to daily obstetric practice. This fourth edition provides the obstetrical team a framework within which to interpret and understand fetal heart rate tracings and their implications. The text covers key issues such as the physiological basis for monitoring, a discussion of fetal hypoxemia and neonatal encephalopathy, instrumentation and pattern recognition. In addition to an in-depth review of the standardized NICHD nomenclature and three-tiered FHR Category approach, there are chapters on intrapartum and antepartum management as well as fetal central nervous system effects on monitor patterns. Since fetal monitoring is primarily a screening tool there are also discussions on the use of backup methods for evaluation of abnormal patterns. This 4th edition also brings the addition of Lisa A. Miller CNM, JD, who provides a nursing and midwifery perspective as well an enhanced legal and risk management review. This new fourth edition includes: review of neonatal encephalopathy and recent studies on CP; current information and discussion of most recent NICHD panel recommendations, both antepartum and intrapartum; new chapter on Pitfalls in EFM; detailed chapter on risk management, liability & documentation; new section on fetal maternal hemorrhage; update on new instrumentation; and crucial information on maternal/fetal coincidence and FDA warnings. All chapters include updated practice tips and clinical implications for the entire obstetric team. Plus, with this edition clinicians have access to a companion website with full text and an image bank for fast & simplified clinical review.
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"The book succeeds at becoming the definitive textbook for antepartum surveillance."
"This is a welcome update of this book on the interpretation and management of fetal tracing. The revision was necessary given the significant changes in terminology. It would have been great if more new data had emerged about the management of tracings, but that is not a limitation of the book as much as a limitation of the science around improvements."
- Doody's Book Review (November 2012)
Anthony Shanks, MD(Washington University School of Medicine)
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