Philips FM20 - Confirm Fetal Life Before Using the Monitor

1 Introduction
10
• Monitor refers to the entire fetal/maternal monitor. Display refers to the physical display unit.
Screen refers to everything you see on the monitor's display, such as measurements, alarms,
patient data, and so forth.
FM30 • Whenever a monitor’s identifier appears to the left of a heading or paragraph, it means that the
information applies to that monitor only. Where the information applies to all models, no
distinction is made.
Avalon CL
Avalon CTS
Whenever one of these identifiers appear to the left of a heading or paragraph, it means that the
information applies to that cableless transducer system. Where the information applies to both
systems, no distinction is made.
For installation instructions and technical description, see the corresponding Service Guide of the fetal
monitors.
Confirm Fetal Life Before Using the Monitor
Fetal monitoring technology available today is not always able to differentiate a fetal heart rate (FHR)
signal source from a maternal heart rate (MHR) source in all situations. Therefore, you should confirm
fetal life by independent means before starting to use the fetal monitor, for example, by palpation of fetal
movement or auscultation of fetal heart sounds using a fetoscope, stethoscope, or Pinard stethoscope.
If you cannot hear the fetal heart sounds, and you cannot confirm fetal movement by palpation,
confirm fetal life using obstetric ultrasonography. Continue to confirm that the fetus is the signal
source for the FHR during monitoring.
Be aware that:
• a maternal HR trace can exhibit features that are very similar to those of an FHR trace, even
including accelerations and decelerations. Do not rely solely on trace pattern features to identify a
fetal source.
• Fetal Movement Profile (FMP) annotations on a fetal trace alone may not always indicate that the
fetus is alive. The body of a deceased fetus can move and cause the monitor to annotate fetal body
movements.
Here are some examples where the maternal HR can be misidentified as the FHR.
When using an ultrasound transducer:
• It is possible to pick up maternal signal sources, such as the aorta or other large vessels.
• Misidentification may occur when the maternal HR is higher than normal (especially when it is
over 100 bpm).
When using a fetal scalp electrode:
• Electrical impulses from the maternal heart can sometimes be transmitted to the fetal monitor
through a recently deceased fetus via the spiral scalp electrode cable, appearing to be a fetal signal
source.
• The recorded maternal HR (and any artifact) can be misinterpreted as an FHR (especially when it
is over 100 bpm).
When Fetal Movement Profile (FMP) is enabled:
FMP annotations in the absence of fetal life may be a result of:
• Movement of the deceased fetus during or following maternal movement.
• Movement of the deceased fetus during or following manual palpation of fetal movement
(especially if the pressure applied is too forceful).