Electronic Fetal Heart Rate Monitoring: The 5-Tier System: The 5-Tier System

by Julian T. Parer, Tekoa L. King, Tomoaki Ikeda

Overview

Electronic Fetal Heart Rate Monitoring: The 5-Tier System, Third Edition reviews the practice of fetal heart rate monitoring. Beginning with a description of the anatomy of fetal circulation, placental function as a respiratory organ, and acid-base balance, it also presents normal fetal cardiovascular and cerebral metabolism. In addition, the pathophysiologic mechanisms involved in progressive fetal asphyxia are examined via a review of the seminal animal and human studies conducted in this field. Also included is a brief summary of fetal heart rate monitoring technology currently used in clinical practice and standard nomenclature for fetal heart rate characteristics. Variant fetal heart rate patterns and the underlying physiologic mechanisms are presented as well.

Product Details

ISBN-13:	9781284145717
Publisher:	Jones & Bartlett Learning
Publication date:	04/21/2017
Sold by:	Barnes & Noble
Format:	eBook
Pages:	242
File size:	19 MB
Note:	This product may take a few minutes to download.

About the Author

Formerly Professor of Obstetrics, Gynecology&Reproductive Sciences, University of California San Francisco
Journal of Midwifery&Women’s Health, Silver Spring, Maryland, University of California, San Francisco, San Francisco, California
Chair of the Department of Obstetrics&Gynecology, University of Mie, Japan

Table of Contents

Part I History of FHR Monitoring
Chapter 1 Development of intrapartum surveillance
Part II Physiology
Chapter 2 Uteroplacental circulation and respiratory gas exchange
Chapter 3 Fetal cardiorespiratory physiology Fetal cerebral metabolism
Chapter 4 Acid-base physiology
Part III Instrumentation & Techniques
Chapter 5 The fetal heart rate monitor
Part IV Nomenclature & Interpretation
Chapter 6 FHR patterns- nomenclature & definitions
Chapter 7 FHR interpretation- relationship to acidemia, risk of pattern evolution
Part V Clinical Management
Chapter 8 FHR pattern management- 5 tier colour code, Japanese modification
Chapter 9 Modifiers of interpretation and management
Chapter 10 Evidence for effectiveness of 5 tier system- and adoption of the system, with modifications National & International differences- absence of consensus
Part VI Other Aspects
Chapter 11 Antepartum FHR testing
Chapter 12 Asphyxia & brain damage
Chapter 13 Legal aspects

Editorial Reviews

Reviewer: Anthony Shanks, MD (Indiana University School of Medicine)
Description: This is the third edition of a clear and elegant reference on electronic fetal heart rate monitoring (EFM). The novel concept of a five-tier staging system is proposed and defended, adding a unique angle to books on this topic.
Purpose: The purpose is to present the pathophysiology behind electronic fetal monitoring, then provide ways to interpret and manage different patterns. These are good objectives and the authors do a good job with them.
Audience: The book is written at the level of practitioner, although residents learning about EFM would appreciate it.
Features: As other EFM books have done, this one provides the pathophysiology behind monitoring and the rationale behind abnormalities. Figures and tables are excellent, although the color chart — presented on the inside cover — is the stand out. The three-tiered system commonplace in ACOG and modern obstetrics is defined and debated. This book is unique in updating content to reflect a proposed five-tier system that further characterizes abnormal tracings. This wrinkle adds to the readability of a potentially dry topic. I also found the management strategies for abnormal tracings particularly useful. I used this book while creating a talk for interns and found it very insightful. I appreciate the historical mentions, including about the metal pessaries that were used to characterize early decelerations.
Assessment: This is an excellent reference and one that I will be going back to often. It is easy to read and, more importantly, interesting to read.

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