ACOG PRACTICE BULLETIN
CLINICAL MANAGEMENT GUIDELINES FOR OBSTETRICIAN–GYNECOLOGISTS
NUMBER 106, JULY 2009
Replaces Practice Bulletin Number 70, December 2005

Intrapartum Fetal Heart Rate Monitoring: Nomenclature, Interpretation, and General Management Principles
This Practice Bulletin was developed by the ACOG Committee on Practice Bulletins with the assistance of George A. Macones, MD. The information is designed to aid practitioners in making decisions about appropriate obstetric and gynecologic care. These guidelines should not be construed as dictating an exclusive course of treatment or procedure. Variations in practice may be warranted based on the needs of the individual patient, resources, and limitations unique to the …ver más…

A complete clinical understanding of EFM necessitates discussion of uterine contractions, baseline FHR rate and variability, presence of accelerations, periodic or episodic decelerations, and the changes in these characteristics over time. A number of assumptions and factors common to FHR interpretation in the United States are central to the proposed system of nomenclature and interpretation (3). Two such assumptions are of particular importance. First, the definitions are primarily developed for visual interpretation of FHR patterns, but should be adaptable to computerized systems of interpretation. Second, the definitions should be applied to intrapartum patterns, but also are applicable to antepartum observations. Uterine contractions are quantified as the number of contractions present in a 10-minute window, averaged over a 30-minute period. Contraction frequency alone is a partial assessment of uterine activity. Other factors such as duration, intensity, and relaxation time between contractions are equally important in clinical practice. Listed as follows is terminology used to describe uterine