“Electronic systems have the ability to automate the daily
calculation of the woman’s current estimated gestational age, pushing the suggested plans of care to the provider”
When electronic foetal monitoring is not used, clinicians utilize
various listening devices, such as fetascopes and hand-held Doppler devices, to detect foetal heart tones during a woman’s pregnancy and birth. This intermittent auscultation of the foetal heart rate, combined with manual palpation of the mother’s abdomen to identify contractions, has traditionally been used to evaluate fetal well-being. Although effective for low-risk pregnancies and deliveries, allowing the clinician to document and evaluate the discrete foetal heart rate values over time, intermittent auscultation does not provide a way to retrospectively review a visual tracing of the continuous foetal heart rate, which may be desired for high-risk pregnancies. Software can be used in conjunction with electronic foetal monitor devices to support the ability to view, display, record, alert, and store the continuous waveform tracings that are obtained with the foetal monitor. The live data can be shared in real time, both at the bedside and remotely, to authorized end users. Electronic foetal monitor systems can support the clinician’s ability to transcribe immediate actions taken on the strip, showing clinical interventions done in response to that tracing. Electronic storage eliminates the need to save the long paper tracing, which provides an easy way to access and review that waveform tracing later on, since it becomes a part of the woman’s permanent lifetime health record, stored electronically. Electronic foetal monitor software offers many exciting new advances, as the technology continues to evolve. For example,
as clinicians move into a more mobile workflow, the live foetal monitor tracing can now be accessed remotely, from commonly- used mobile devices such as smar t phones and other hand-held devices that offer visual displays. Another exciting new technology allows obstetric providers to view, with cer tain types of foetal monitor devices, a foetal ECG tracing. The device can analyze the changes in the ST segment of the foetal ECG waveform and send an aler t to clinician indicating the presence of foetal acidosis, which is a sign of foetal distress. These types of proprietary foetal monitor devices, known as STAN monitors (for ST Analysis), help reduce the ambiguity that is sometimes present when clinicians visually analyze the traditional fetal hear t rate tracing. By pushing more specific information to the clinician, STAN monitors can help the obstetric provider determine a strategy for intervention. For example, the information can help determine whether continued observation is appropriate, or an expeditious surgical delivery is indicated. Software can be developed to allow the data from STAN fetal monitors to be displayed in the woman’s electronic healthcare record, which fur ther enables timely decision suppor t. The goal for obstetric care has always been to achieve the best outcomes possible for pregnant women and their babies. By using technology to create electronic health records to integrate all pertinent clinical data for the entire pregnancy and childbirth experience, safe and timely care can be recognized.
Image © Cerner Corp
032 ARAB HEALTH MAGAZINE ISSUE 2 2012
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