Fetal Heart Rate Monitoring / Edition 4

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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 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
  • Currentinformation 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
  • 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.

"Includes history of the development of the technique, physiology, pattern recognition, technique, case management, & risks and benefits."

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Editorial Reviews

Doody's Review Service
Reviewer: Anthony Shanks, MD (Washington University School of Medicine)
Description: This fourth edition of a book dedicated to the interpretation and management of fetal heart rate tracings incorporates new terminology agreed upon at the last consensus conference.
Purpose: The book describes the physiology, indications, and management for fetal heart rate tracings. Both intrapartum and antepartum conditions are evaluated. The book succeeds at becoming the definitive textbook for antepartum surveillance.
Audience: Residents and physicians in obstetrics/gynecology are the intended audience.
Features: The book is divided into a brief history, physiology, diagnosis, and management of fetal heart rate tracings. I particularly enjoyed the history of fetal monitoring. As today's trainees enter the workforce with such a ubiquitous monitoring system, it is important to reflect on what led us to this point. The physiology section is well presented, but the images could be updated. Figures and illustrations are medically correct but appear old (figure 2.1 is an image from a 1969 publication). Incorporation of the new terminology is also well done. Chapter 3 discusses the complex subject of hypoxia and neonatal encephalopathy with good definitions and figures. However, a figure outlining the risk of stillbirth in various conditions (e.g. chronic hypertension) would have been helpful. This information may have been more suitable in another chapter, but I never came across it. Chapter 8, on clinical management of abnormal fetal heart rate patterns, is solid and the sample tracings give readers sufficient exposure to practice their interpretations. Some of the suggested maneuvers may come across as overly simple, but should still be explained for the purposes of this book.
Assessment: 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.
From the Publisher
"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)

The revised and updated edition (first edition, 1981) of this comprehensive textbook adds new technologies such as ultrasound biophysical assessment, fetal acoustic stimulation, and amnioinfusion, and new chapters including discussions of management of fetal distress in premature gestation, FHR patterns associated with CNS dysfunction, and common pitfalls in FHR monitoring. Annotation c. Book News, Inc., Portland, OR (booknews.com)
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Product Details

  • ISBN-13: 9781451116632
  • Publisher: Lippincott Williams & Wilkins
  • Publication date: 5/17/2012
  • Edition description: Fourth
  • Edition number: 4
  • Pages: 288
  • Sales rank: 1,531,605
  • Product dimensions: 8.60 (w) x 11.10 (h) x 0.70 (d)

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