Non reassuring fetal heart rate (NRFHR) is a concerning finding during pregnancy or labor, as it can indicate fetal distress and potential for adverse outcomes. The presence of NRFHR warrants prompt evaluation and possible intervention to ensure the well-being of both the mother and the fetus. Key characteristics of NRFHR include late decelerations, variable decelerations, prolonged decelerations, and bradycardia. These patterns often reflect a decrease in fetal oxygenation and require immediate attention from healthcare providers.
Non-reassuring Fetal Heart Rate
Non-reassuring fetal heart rate (FHR) indicates that the baby’s health may be in jeopardy. The FHR is normally between 110 and 160 beats per minute (bpm). If the FHR is less than 110 bpm or greater than 160 bpm, it is considered non-reassuring.
Causes of Non-reassuring Fetal Heart Rate
- Maternal fever
- Infection
- Fetal anemia
- Placental abruption
- Umbilical cord compression
- Fetal distress
Signs and Symptoms of Non-reassuring Fetal Heart Rate
- Tachycardia: FHR greater than 160 bpm
- Bradycardia: FHR less than 110 bpm
- Late decelerations: Decelerations in the FHR that occur after the peak of a contraction
- Variable decelerations: Decelerations in the FHR that vary in shape and timing
- Prolonged decelerations: Decelerations in the FHR that last more than 60 seconds
- Sinusoidal pattern: A pattern of FHR that is smooth and without any variability
Management of Non-reassuring Fetal Heart Rate
The management of non-reassuring FHR will depend on the underlying cause. The healthcare provider will likely perform the following:
- Get the mother in the left lateral position. This position can help improve the blood flow to the baby.
- Give the mother oxygen. This can help improve the oxygenation of the baby.
- Start an IV line. This will allow the healthcare provider to give the mother fluids and medications as needed.
- Monitor the FHR closely. The healthcare provider will use a fetal monitor to monitor the FHR and identify any changes.
- If the FHR does not improve, the healthcare provider may need to deliver the baby early. This may be necessary to prevent the baby from being harmed.
Table summarizing FHR patterns and their causes and management
| FHR Pattern | Cause | Management |
|---|---|---|
| Tachycardia (FHR > 160 bpm) | Maternal fever, infection, fetal anemia | Get mother in left lateral position, give oxygen, start IV line, administer fluids and medications as needed, monitor FHR closely, deliver baby early if necessary |
| Bradycardia (FHR < 110 bpm) | Fetal distress, hypoxia | Get mother in left lateral position, give oxygen, start IV line, administer fluids and medications as needed, monitor FHR closely, deliver baby early if necessary |
| Late decelerations | Placental abruption, umbilical cord compression | Get mother in left lateral position, give oxygen, start IV line, administer fluids and medications as needed, monitor FHR closely, deliver baby early if necessary |
| Variable decelerations | Fetal head compression, cord compression | Reposition mother, give oxygen, start IV line, administer fluids and medications as needed, monitor FHR closely, deliver baby early if necessary |
| Prolonged decelerations | Fetal distress, hypoxia | Get mother in left lateral position, give oxygen, start IV line, administer fluids and medications as needed, monitor FHR closely, deliver baby early if necessary |
| Sinusoidal pattern | Fetal distress, fetal death | Deliver baby immediately |
Question 1:
What is a non-reassuring fetal heart rate (FHR)?
Answer:
A non-reassuring fetal heart rate (FHR) is an abnormal FHR pattern that indicates potential fetal distress or compromise. It is characterized by deviations from normal baseline patterns, such as:
- Bradycardia (FHR below 110 bpm)
- Tachycardia (FHR above 160 bpm)
- Variability (absence of normal beat-to-beat changes in FHR)
- Decelerations (abnormal decreases in FHR during contractions)
Question 2:
What are the causes of non-reassuring fetal heart rate patterns?
Answer:
Non-reassuring FHR patterns can be caused by various factors, including:
- Fetal hypoxia (lack of oxygen)
- Placental insufficiency (inadequate blood flow to the fetus)
- Umbilical cord compression
- Maternal hypotension (low blood pressure)
- Intrauterine growth restriction
- Fetal anomalies
Question 3:
How is a non-reassuring fetal heart rate pattern evaluated?
Answer:
Evaluation of a non-reassuring FHR pattern involves:
- Assessment of baseline FHR
- Calculation of variability
- Analysis of decelerations
- Determination of the overall FHR pattern
- Identification of potential underlying causes
- Monitoring of maternal conditions
- Serial FHR assessments over time
Thanks for reading! If you’re a pregnant woman, I know this topic can be scary, but there’s no need to panic. Just remember that your healthcare provider is your best source of information and support, so don’t hesitate to reach out if you have any questions or concerns. Stay tuned for more articles on pregnancy and childbirth, and remember, we’re always here to support you on your journey to motherhood.