Fetal Monitoring in Practice
- 5th Edition - February 16, 2023
- Imprint: Churchill Livingstone
- Editors: Donald Gibb, Sabaratnam Arulkumaran
- Language: English
- Paperback ISBN:9 7 8 - 0 - 3 2 3 - 9 3 1 4 5 - 8
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 9 3 1 5 4 - 0
The latest edition of this popular book is essential reading for all midwives and doctors working in the labour ward.It has been fully updated but retains the essential features t… Read more
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Request a sales quoteThe latest edition of this popular book is essential reading for all midwives and doctors working in the labour ward.
It has been fully updated but retains the essential features that have contributed to its popularity – an accessible writing style, easy-to-understand explanation of CTGs, and case studies and illustrations to make the content as accessible and practical as possible.
Fetal monitoring is a challenging area that requires skill and experience to practise well. This volume explores the subject matter in a detailed but straightforward manner, thus becoming an invaluable resource for health practitioners as well as midwifery and medical students.
- Fully updated by internationally renowned editors
- Illustrations and case histories make content applicable to practice
- Clear and friendly writing demystifies a potentially challenging subject area
- Explains the correct use of terminology to help ensure safe and accurate communication
- Covers the basics of interpretation, common pitfalls associated with equipment usage, and clinical trial data in context
- Explains the underlying pathophysiology associated with abnormal changes seen on the CTG
- Clinical scenarios demonstrate common presentations such as breech birth, twin pregnancies, brow presentation, hypertension, and eclampsia
- Real CTG traces demonstrate more complex presentations such as prolonged deceleration, placental abruption, and fetal bleeding
Practising midwives, student midwives
- Cover image
- Title page
- Table of Contents
- Copyright
- Foreword
- Preface to the Fifth Edition
- List of Contributors
- 1. Introduction
- 2. Clinical Assessment and Recording
- 3. Intermittent Auscultation Of the Fetal Heart Rate
- Locating The Fetal Heart Rate
- Instruments Used For Fetal Auscultation
- Intrapartum Care
- Intelligent Intermittent Auscultation
- Technique
- Escalation
- Conclusion
- 4. Electronic Fetal Monitoring:: Terminology And Interpretation – The Basics
- Paper Speed
- Problems Associated With The Interpretation Of Baseline Variability
- Correct Identification Of Baseline Heart Rate
- False or Erroneous Baseline Because of Double Counting of Low Baseline FHR
- Problems Associated With Interpretation Of Traces
- 5. Pathophysiology of Fetal Heart Rate (FHR) Patterns
- Pathophysiological Mechanisms of Decelerations
- Baseline Variability and Decelerations – Exception to the Rule
- Classification of Fetal Heart Rate Pattern
- Practical Hints to Identify Gradual Deterioration of Fetal Condition (Fig. 5.24)
- Practical Hints to Identify Possible Acute Deterioration Of FETAL Condition (Fig. 5.25)
- 6. Interpretation of Intrapartum Cardiotocography
- Guideline Development
- Cardiotocography Analysis
- Clinical Management
- Conclusion
- 7. Antepartum Fetal Surveillance
- Identification of the Fetus at Risk
- Fetal Growth
- Biophysical Assessment of Fetal Health
- Case Illustrations
- Prolonged Pregnancy
- 8. The Admission Test by Cardiotocography or by Auscultation
- Admission Test by Auscultation (‘Intelligent Auscultation’)
- Studies on Admission Cardiotocography
- Randomized Controlled Trials on Admission Test
- Other Forms of Admission Test
- Assessment of Amniotic Fluid Volume
- Relationship of Neurologically Impaired Term Infants to Results of Admission Test
- Planning Management
- 9. Assessment of Uterine Contractions
- Contraction Assessment
- Clinical Application
- Contraction Monitoring With The Use Of Prostaglandins For Induction Of Labour
- Contraction Monitoring After External Cephalic Version
- Contraction Monitoring In Cases Of Suspected Abruption
- 10. The use of Oxytocin and FHR Changes
- Medico-Legal Considerations
- 11. Meconium, Infection, Anaemia and Bleeding
- Increasing Fetal Risk
- Meconium
- Infection
- Fetal Anaemia
- Maternal Bleeding
- 12. Cardiotocographic Interpretation – Additional Clinical Scenarios
- Twin Pregnancy
- Breech Presentation
- Brow Presentation
- Previous Caesarean Section: Trial of Labour with a Scar
- Severe Hypertension
- Eclampsia
- Medication
- Epidural Anaesthesia
- Second Stage of Labour
- Prolonged Decelerations in the first Stage of Labour
- 13. Cardiotocographic Interpretation:: More Difficult Problems
- Prolonged Deceleration (Bradycardia)
- The Dying Fetus due to Gradually Developing Hypoxia
- Recording of the Maternal Heart Rate that can MIMIC the Fetal Heart Rate
- 14. Fetal Scalp Blood Sampling
- Respiratory and Metabolic Acidosis
- When to do Fetal Blood Sampling
- When not to do Fetal Blood Sampling
- Alternatives to Fetal Blood Sampling for pH
- Points to Ponder
- 15. Fetal Electrocardiograph Waveform Analysis
- Assessment of the Brain and the Heart by Combined CTG and ECG Waveform Analysis
- Fetal ECG–ST Waveform Analysis
- Stan Monitoring and new International Federation of Obstetrics and Gynecology (FIGO) Guidelines on CTG Classification
- Current State of Evidence on Stan Monitoring
- Conclusion
- 16. Medicolegal Issues With Cardiotocograph and Current Strategies to Reduce Litigation
- Should we be using Continuous Electronic Monitoring of Fetal Heart Rate and Uterine Contractions During Labour?
- The Incidence of Substandard Care as a Contributor to Poor Outcome
- The Medicolegal Crisis
- Training in Cardiotocograph Interpretation
- A particular medicolegal risk is associated with the use of oxytocin infusion to augment labour when the CTG is nonreassuring or abnormal/pathological.
- The Principles of Legal Practice as Applied to Medicine
- The way Forward
- 17. Fetal Wellbeing in Labour – National Initiatives, Challenges and the Future
- The National Ambition
- Introduction to National Initiatives
- Impact of these National Initiatives on Intrapartum Brain Injury
- Intrapartum Fetal Monitoring: Targets for Improvement
- Contributory Factors to Adverse Outcomes According to Each Baby Counts
- Where to Focus our Efforts?
- Conclusion
- 18. Reflections and Conclusion
- INDEX
- Edition: 5
- Published: February 16, 2023
- Imprint: Churchill Livingstone
- Language: English
- Paperback ISBN: 9780323931458
- eBook ISBN: 9780323931540
DG
Donald Gibb
Affiliations and expertise
Independent Obstetrician and Gynaecologist, The Birth Company (part of The Portland Hospital), Harley Street, London, UKSA
Sabaratnam Arulkumaran
Sir Sabaratnam Arulkumaran, PhD, DSc, FRCOG, FRCS, FACOG, Emeritus Professor of Obstetrics and Gynaecology (O&G) of St. George’s University, London; Foundation Professor of O&G, University of Nicosia, Visiting Professor, Institute of Global Health Innovation, Imperial College, London; Past President of the Royal College of Obstetricians and Gynaecologists (2007-2010); President: International Federation of Obstetrics & Gynaecology (FIGO) 2012-2015; Head, Dept. of Obstetrics & Gynaecology, St George’s University Hospital, London, UK (1997-2013). National award recipient of Knight Bachelor in the UK and Sri Lanka Ranjana in Sri Lanka for services to Medicine.
Affiliations and expertise
Professor Emeritus, Division of Obstetrics and Gynaecology, St George’s University of London, London, UK