Contents

1. Acknowledgements
2. Introduction
   1. About Bettercare
   2. Why decentralised learning?
   3. Free Bettercare Online Learning Station
   4. Learning programmes
   5. Format of the courses
   6. Contributors
   7. Updating the course material
   8. Contact information
   9. Registration
3. About this book
4. 1. Understanding the fetus during labour
   1. 1. What is fetal wellbeing?
   2. 2. How is the condition of the fetus monitored clinically during pregnancy?
   3. 3. Is it helpful to count the fetal heart rate during pregnancy?
   4. 4. What clinical signs can be used to monitor the fetal condition during labour?
   5. 5. What else should be monitored during labour?
   6. 6. How do you decide whether a woman is in labour?
5. 2. Monitoring the fetal heart rate during labour
   1. 7. What are the stages of labour?
   2. 8. Should the fetal heart rate always be monitored in labour?
   3. 9. Should the fetal heart rate be monitored throughout labour?
   4. 10. How can the fetal heart rate be monitored?
   5. 11. What are the advantages and disadvantages of a fetal stethoscope?
   6. 12. What are the advantages and disadvantages most fetal monitors?
   7. 13. What are the advantages and disadvantages of a cardiotocograph?
   8. 14. Which method of fetal heart rate monitoring should be used?
   9. 15. What are the advantages of the Philips fetal monitor?
   10. 16. Why is it so important to monitor the fetal heart rate during labour?
6. 3. Fetal stress during labour
   1. 17. What may stress the fetus during labour?
   2. 18. How does head compression affect the fetus?
   3. 19. What may reduce the supply of oxygen to the fetus?
   4. 20. How do contractions reduce the supply of oxygen to the fetus?
   5. 21. How does the fetus obtain an adequate supply of oxygen during normal uterine contractions?
   6. 22. When do uterine contractions reduce the supply of oxygen to the fetus?
   7. 23. How does the fetus respond to a lack of oxygen during labour?
   8. 24. How is fetal distress recognised during labour?
7. 4. Assessing the fetal condition during labour
   1. 25. How do you assess the condition of the fetus during labour?
   2. 26. What is the importance of meconium-stained amniotic fluid?
8. 5. Assessing fetal heart rate
   1. 27. How should you monitor the fetal heart rate?
   2. 28. How often should you routinely monitor the fetal heart rate?
   3. 29. Which women are considered to have a high risk of fetal distress?
   4. 30. How often must the fetal heart rate be monitored if there is a high risk of fetal distress?
   5. 31. What features of the fetal heart rate pattern should you always assess during labour?
   6. 32. What is the normal baseline fetal heart rate?
   7. 33. What is a deceleration?
   8. 34. How do decelerations relate to the timing of contractions?
   9. 35. What is an acceleration?
   10. 36. What fetal heart rate patterns can easily be recognised with a fetal monitor?
9. 6. Fetal heart rate patterns
   1. 37. What is the normal fetal heart rate pattern during labour?
   2. 38. What is the importance of a normal fetal heart rate pattern?
   3. 39. Which fetal heart rate patterns are not normal during labour?
   4. 40. What is a baseline tachycardia?
   5. 41. What are the causes of a baseline tachycardia?
   6. 42. What is a baseline bradycardia?
   7. 43. What is the cause of a baseline bradycardia?
   8. 44. What are early decelerations?
   9. 45. What is the significance of early decelerations?
   10. 46. What are late decelerations?
   11. 47. What is the significance of repeated late decelerations?
   12. 48. What are variable decelerations?
   13. 49. How should you assess the condition of the fetus on the basis of the fetal heart rate pattern?
   14. 50. Which fetal heart rate patterns indicate an increased risk of fetal distress during labour?
   15. 51. What fetal heart rate patterns indicate fetal distress during labour?
   16. 52. What questions should be asked when the fetal heart rate pattern is assessed during labour?
   17. 53. What fetal heart rate pattern is abnormal during the second stage of labour?
10. 7. Using a partogram
    1. 54. What is a partogram?
    2. 55. How are the fetal observations recorded on the partogram?
11. 8. Managing a woman with fetal decelerations
    1. 56. What is the management of a woman with decelerations?
12. 9. Managing fetal distress
    1. 57. What is the management of a woman with fetal distress?
    2. 58. What is fetal resuscitation?
13. 10. When to use a cardiotocograph
    1. 59. When should a cardiotocograph (CTG) trace be obtained?