Improper Fetal Heart Rate Monitoring

Fetal monitoring refers to the process of listening to and interpreting the heartbeat patterns of a baby during labor and delivery. Fetal heart rate monitoring can help medical professionals (specifically labor and delivery nurses and obstetricians) evaluate an unborn baby’s health. If the baby’s heart rate is too high (tachycardia), too low (bradycardia), this is a sign of fetal distress.

Fetal distress can mean that the baby’s body is trying to compensate for oxygen-depriving conditions. Fetal distress and abnormal heart rates could be caused by a chronic (long-lasting) issue such as uteroplacental dysfunction or an acute (short-term) issue like uterine tachysystole/hyperstimulation. Fetal distress can cause a baby to suffer a birth injury if the distress is not stopped or the baby is not delivered depending upon the circumstances.

If medical professionals fail to use fetal heart rate monitors as indicated, use monitors incorrectly, improperly interpret monitor readouts, or fail to intervene when necessary, the consequences could be serious. If the baby is harmed by negligent actions of labor and delivery nurses and doctors (including Obstetricians or Maternal Fetal Medicine specialists) related to fetal heart rate monitoring, this constitutes medical malpractice/medical negligence.

Interpreting FHR Patterns The Fetal Heart Rate (FHR) pattern information together with the measurement of the mother's contractions is referred to as Electronic Fetal Monitoring (EFM) tracings. The EFM tracings provide critical insight into the level of stress the baby is under during labor and birth. The FHR monitor identifies the normal baseline heart rate and then tracks how the rate rhythm accelerates and decelerates during each contraction.

Heart Rate Variability There are certain fetal heart rate ranges in unborn babies that can indicate their health status. Heart rate variability (HRV) is the fluctuation in the time intervals between adjacent heartbeats.

*Persistently minimal or absent FHR variability appears to be the most significant sign of fetal compromise.

Absent Variability

Minimal Variability - below 6 bpm and absent when non visible (Increased risk of fetal acidemia)

Moderate Variability – presence of Accelerations and no Decelerations (6-25bpm) Healthy baby

Marked Variability - may represent an increased response due to a stressful event

Normal fetal heart rate (baseline): approximately 110bpm – 160bpm
Slow fetal heart rate (bradycardia): under 110bpm
Fast fetal heart rate (tachycardia): more than 160bpm

Tachycardia – High Fetal Heart Rate Tachycardia can mean that the baby’s heart is working harder than normal to pump blood and oxygen to the rest of the body. This is a compensatory mechanism that can help offset low oxygen conditions. Sustained tachycardia puts babies at risk for cardiovascular failure.

Bradycardia – Slow Fetal Heart Rate Bradycardia can be caused by a number of factors. In many cases, it results from fetal oxygen deprivation caused by dangerous complications such as uterine tachysystole/hyperstimulation, placental abruption, or uterine rupture. It can also be caused by maternal health issues, such as hypotension or seizures.

Interpreting the acceleration and deceleration FHR patterns in response to contractions tells doctors and nurses if the baby is under duress and may not be getting enough oxygen.

Deceleration refers to how the FHR slows down after a contraction. During a contraction, the FHR speeds up (acceleration) due to the compression of the placenta as the mother's uterus muscles push the baby through the birth canal.

Fetal heart rate patterns are classified as reassuring, nonreassuring or ominous. Nonreassuring patterns such as fetal tachycardia, bradycardia and late decelerations with good short-term variability require intervention to rule out fetal acidosis. Ominous patterns require emergency intrauterine fetal resuscitation and immediate delivery if they cannot be quickly corrected.

When contractions end the baby's FHR normally slows down (decelerates) in a slow, even pattern and eventually returns to the normal baseline FHR. When FHR does not decelerate in a normal pattern after a contraction it is a key indication that the baby is in distress.

Late decelerations are signs of fetal distress. They are different than “early” decelerations in that they begin at or after the high point (nadir) of the contraction and are a gradual deceleration. These must be responded to immediately and if they persistent the baby must be delivered even if by Cesarean section/c-section.

Variable decelerations are abrupt (rather than gradual) decreases from the baseline without regard to the timing of any contraction. When variable decelerations are combined with minimal or absent variability intervention is required and if no improvement is seen, the baby must be delivered.

The fetal monitoring strip is the window into the healthiness of your unborn baby (“fetus”). Labor and delivery nurses, obstetricians and maternal-fetal medicine specialists must closely watch the strips. If signs of fetal distress are present and they persist your baby needs to be delivered. If these medical professionals fail to react to fetal distress on the fetal monitoring strips and your baby suffers an injury, the hospital, nurses and doctors may well be responsible for their medical malpractice/medical negligence leading to your baby’s birth injury.

There is nothing more traumatic than your child suffering a birth injury. Many birth injuries cause serious medical problems that could end in lifetime disability. The Texas Birth Injury Attorneys at Miller Weisbrod understand the significant impact a birth injury will have not only on your child's life, but also your own. As experienced Birth Injury Lawyers, we fight hard for answers and justice if a delivery room error or doctor's negligence caused your child's birth injury.

If your child suffered a serious injury or lifetime disability due to a mistake before, during or after delivery, a lawsuit may be the best way to find out once and for all what happened and who is to blame. Contact us today to schedule a free consultation with an experienced Birth Injury Lawyer. We encourage you to call our offices today at 214.987.0005 or toll free at 888.987.0005 for your free consultation.