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Are there problems associated with fetal monitoring?

The benefits of fetal monitoring are limited by human error.  Clinicians often make mistakes in their interpretation of fetal monitoring strips.  In addition, any dangerous deviations in heart rate must be diagnosed in a timely manner in order to prevent dangerous complications.

Reading fetal monitoring strips

It is important that clinicians have proper education and training to interpret fetal monitoring strips.  Nurses often spend more time with patients, so they can usually read the strips better than doctors can.  Therefore, the nurses must be trained to deploy resources for an emergency delivery or emergency response if the fetal tracings signal a problem.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) released figures on the root causes of perinatal deaths and injuries from 1995 to 2004.  The top two causes were communication and orientation/training, which included issues related to accurate interpretation of fetal assessment information.

Fluctuating fetal heart rate patterns

When the mother is pushing during delivery, problems can occur with the fetal tracings.  In addition, the position, station, and shape of the fetal head can also affect the fetal heart rate patterns.  This increases the chances of possible misreading of the fetal monitoring strips.  Difficulties with tracing interpretation are further complicated by the lack of standardized nomenclature and criteria for fetal monitoring patterns.

Responsibility of the medical team to respond to distress

Furthermore, caregivers must have a care plan in place to respond to the information provided by the fetal monitoring strips.  Therefore, when a fetus shows dangerous changes in fetal heartbeat, nurses and doctors need to be prepared to respond.

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