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Volume 42, Issue 12
Publication date: June 1, 2017
Expiration date: June 1, 2020

Pearls and Pitfalls in Interpreting Intrapartum Fetal Heart Rate Monitoring
David A. Miller, MD (Moderator)
Professor of Obstetrics, Gynecology, and Pediatrics, Keck School of Medicine, University of Southern California; Chief, Division of Maternal-Fetal Medicine, Children’s Hospital Los Angeles, Los Angeles, California

Sean C. Blackwell, MD
Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas

Haywood L. Brown, MD
F. Bayard Carter Professor and Chair Emeritus, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina

Learning Objectives
After completing this activity, the physician should be better able to:
1. Recognize that fetal heart rate monitoring is a screening test for transient interruption of fetal oxygenation during labor, not a diagnostic test for current or impending hypoxic neurologic injury.
2. Articulate a rational approach to the definitions of fetal heart rate patterns encountered in clinical practice, focusing on the definition of variability.
3. Avoid terms that lack standard definitions, such as “reassuring,” “nonreassuring,” “fetal distress,” and “ominous pattern.”
4. Avoid common pitfalls in intrapartum monitoring, such as inadvertent monitoring of the maternal heart rate instead of fetal heart rate.
5. Understand and articulate the definitions, capabilities and limitations of fetal heart rate Categories I, II and III.
6. Explain a rational approach to managing persistent Category II fetal heart rate patterns.

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