Re: [ozmidwifery] fetal heart monitoring.

[Alesa Koziol]

We are now using the RANZCOG guidelines, which cite the NICE guidelines as one of the reference sources (just personally I find these guidelines incredibly restrictive for the labouring woman). A update on the guidelines is due out early August. Current version is available online although I cant seem to find it at the moment. Cheers Alesa Alesa Koziol Clinical Midwifery Educator Melbourne ----- Original Message ----- From: Sally Westbury To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 9:13 AM Subject: [ozmidwifery] fetal heart monitoring. I’ve been looking at patterns of intermittent auscultation for midwifery practice. It seems that little is published outside the NICE guidelines but the ACOG say The American College of Obstetricians and Gynecologists (ACOG) states that with specific intervals, intermittent auscultation of the FHR is equivalent to continuous EFM in detecting fetal compromise.4 ACOG has recommended a 1:1 nurse-patient ratio if intermittent auscultation is used as the primary technique of FHR surveillance.4 The recommended intermittent auscultation protocol calls for auscultation every 30 minutes for low-risk patients in the active phase of labor and every 15 minutes in the second stage of labor.4 Continuous EFM is indicated when abnormalities occur with intermittent auscultation and for use in high-risk patients. Table 1 lists examples of the criteria that have been used to categorize patients as high risk. http://www.aafp.org/afp/990501ap/2487.html Would anyone like to share their guidelines?   Sally Westbury