Introduction

Figure 16.1 Monitoring the Fetus and Uterine Contractions External transducers evaluate the fetal heart rate and uterine contractions. (credit: “A glimpse into Labor and Delivery” by Airman 1st Class Kaylee Dubois, U.S. Air Force/Joint Base Langley-Eustis, Public Domain)

Chapter Outline

16.1 Basic Terms of Fetal Heart Rate and Contraction Patterns

16.2 External and Internal Monitoring

16.3 Physiological Influences on Fetal Heart Rate Patterns

16.4 Nursing Interventions Based on Fetal Heart Rate and Uterine Contraction Patterns

16.5 Intrauterine Resuscitation

During labor, the pregnant person and fetus are monitored for safety and progression of labor. Fetal assessment involves evaluating the fetal heart rate in response to uterine contractions. Fetal assessment can be determined by either continuous electronic fetal monitoring or intermittent fetal monitoring. The nurse initiates the type of fetal monitoring using hospital protocols or orders written by health-care providers and the preferences of the laboring person.

This chapter covers monitoring of FHR and UC patterns and their relationship to fetal well-being. Nurses working on perinatal units are trained to read fetal monitor tracings and can be certified in fetal monitoring by the National Certification Corporation (2023). This chapter describes the physiologic influences on FHR and UC patterns and how the nurse can recognize the need for intervention. Intrauterine resuscitation is used when the FHR shows signs of decreased oxygenation to the fetus. The labor and delivery nurse is proficient in recognizing the need for intrauterine interventions.