10 Monitoring FHR and FMP Using Ultrasound
111
Selection of Literature References on Artifacts
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Fetal Monitoring, A Multidisciplinary Approach, Sixth edition
Susan M. Tucker, Lisa A. Miller, David A. Miller
Mosby Inc. 2009, ISBN 978-0-323-05670-0
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Signal ambiguity resulting in unexpected outcome with external fetal heart rate monitoring
By Duncan R. Neilson Jr, MD; Roger K. Freeman, MD; Shelora Mangan, RNC, MSN, CNS
American Journal of Obstetrics & Gynecology, June 2008:
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Antepartal and Intrapartal Fetal Monitoring, 3rd Edition (2007)
By Michelle L. Murray, PhD, RNC
Springer Publishing Company, ISBN 0-8261-3262-6
Page 2, Table 2: Limitations of Continuous EFM
Item 15: “The US may detect maternal aortic wall movement and the MHR will be printed. A failure
to recognize the lack of a FHR may delay appropriate management.”
Page 38, “Solving Equipment Problems”, Table 3: The Ultrasound Transducer
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JOGC (Journal of Obstetrics and Gynaecology Canada)
Volume 29, Number 9, September 2007
Chapter 2: Intrapartum Surveillance
Page S35: “Methods of Electronic Fetal Monitoring”
“… Among its disadvantages are the need for readjustment with maternal or fetal movements and the
following: the transducer may record the maternal pulse, it may be difficult to obtain a clear tracing in
obese women or those with polyhydramnios, artifact may be recorded, and there may be doubling or
halving of the fetal heart rate when it is outside of the normal range.”
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Maternal of Fetal Heart Rate? Avoiding Intrapartum Misidentification
by Michelle L. Murray
JOGNN Clinical Issues, April 2003, 33, 93-104; 2004. DOI: 10.1177/0884217503261161
Figure 9 "The recording is of the MHR with occasional doubling."
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Maternal Heart Rate Pattern – A Confounding Factor In Intrapartum Fetal Surveillance
Schifrin BS, Harwell R, Hamilton-Rubinstein T, Visser G:
Prenat Neonat Med 2001; 6:75-82.
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