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Electronic Fetal Heart Rate Monitoring, Third Edition
The 5-Tier System

Author(s): Julian T. Parer, MD, PhD, Professor of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco
Tekoa L. King, CNM, MPH, FACNM, University of California at San Francisco, Journal of Midwifery & Women’s Health
Tomoaki Ikeda, MD, PhD, Chair of the Department of Obstetrics & Gynecology, University of Mie, Japan
Details:
  • ISBN-13: 9781284090338
  • Paperback    242 pages      © 2018
Price: $72.95 US List
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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.

The Third Edition summarizes the research identifying the relationship between specific fetal heart rate patterns and an increasing risk of fetal acidemia, including the effect of deceleration depth, duration, and pattern evolution. It also evaluates the scientific basis that supports management algorithms currently in use and recommends the Parer/Ikeda 5-tier system. This algorithm assigns fetal heart rate patterns to 5 categories based on their progressive risk of fetal acidemia and has been tested in several studies. Clinical management using the 5-tier system is presented in detail.

Applicable Courses

Essentials of Obstetrics and Fetal Heart Rate Monitoring, Interpretation of Fetal Heart Rate Monitoring, Fetal Evaluation, Care of the High Risk Pregnancy, Antepartum

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

Julian T. Parer, MD, PhD-Professor of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco

Julian T. Parer MD, PhD is a Professor of Obstetrics, Gynecology & Reproductive Sciences at the Univ of California San Francisco. Since 1974 he has done, and continues to do, clinical care in Maternal Fetal Medicine, teaching and research, and is widely published. He Chaired the first National Institutes of Child Health and Human Development consensus conferences on FHR monitoring in 1997, was a member of the 2008 NICHD conference on the same topic, and is currently a member of the consensus committee of the Federation of International Societies of Gynecology & Obstetrics.

Tekoa L. King, CNM, MPH, FACNM-University of California at San Francisco, Journal of Midwifery & Women’s Health

Associate Professor Department of Obstetrics, Gynecology, and Reproductive Sciences University of California at San Francisco San Francisco, California Deputy Editor Journal of Midwifery & Women’s Health

Additional Titles by this Author

Tomoaki Ikeda, MD, PhD-Chair of the Department of Obstetrics & Gynecology, University of Mie, Japan

Tomoaki Ikeda MD, PhD, Is Chair of the Department of Obstetrics & Gynecology at the University of Mie, Japan. He has a long history of clinical care, education and research in care of the fetus. As noted above he is a lead maternal Fetal Medicine specialist in the dissemination of the standardized approach to FHR management throughout the whole of Japan, potentially optimizing care for over 1 million Japanese babies per year.

  • “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.” - Anthony Shanks, MD, Indiana University School of Medicine, for Doody’s Review Service