Introduction to appropriate use of terms describing FHR patterns

Appropriate clinical management of various fetal heart rate (FHR) patterns is dependent on the use of standardized definitions that have been determined by the NICHD. Adopting a common language for FHR pattern definitions and documentation is agreed upon by providers to enhance communication among care givers and therefore, enhance maternal-fetal safety. Timely intervention during non reassuring FHR patterns is dependent on clear communication between providers who are caring for the individual patient. There are several patterns that are predictive of current or impending fetal asphyxia so severe that the fetus is at risk for neurologic and other fetal damage. Members of the perinatal team have a shared method of interpreting FHR patterns and management guidelines.
A full description of an EFM tracing requires a qualitative and quantitative description of:
            1. Uterine contractions
            2. Baseline FHR
            3. Baseline FHR variability
            4. Presence of accelerations
            5. Periodic or episodic decelerations
            6. Changes or trends of FHR patterns over time

Next posting will include fetal heart characteristics and pattern definitions.


Macones, G., Hankins, G., Spong, C., Hauth, J., and Moore, T. (2008). The 2008 National Institute of Child Health and Development Workshop Report on Electronic Fetal Monitoring. Obstetrics and Gynecology, 112 (3), pp. 661-666.

Simpson, K. & Creehan, P. (2008). Fetal assessment during labor. In Perinatal Nursing, 3^rd ed.  Philadelphia, Pa.: Lippincott, Williams, and Wilkens