Hi Robyn
Thank you for this information. I agree with you that early and lates
should be distinguished from typical and atypical variable. I think the
NICE Intrapartum guidelines 2007 also refer to late and early
decelerations as well as variable typical and atypical, although they
state that early decelerations are not significant. Thanks again
Mary
P.S Will email you later and update you with my work so far
Mary Longworth
Midwifery Lecturer
Fron Heulog
School of Health Care Sciences
Friddoedd Road
Bangor
[log in to unmask]
Tel No. 01248 383158
Robyn Maude [CCDHB] wrote:
>
> Hi Mary
>
> We have been using the guideline from RANZCOG at our hospital for some
> time now and also access their fetal surveillance programme FSEP. The
> link to the guideline is below and the definitions are in appendix E
>
> http://www.ranzcog.edu.au/publications/pdfs/ClinicalGuidelines-IFSSecEd.
> pdf
>
> Decelerations are still described as Early, Late, Variable, Complicated
> Variable, Prolonged in this guideline.
>
> The FSEP teaches form a physiological perspective rather than pattern
> recognition.
>
> I have done a guideline comparison for my PhD work and it seems the
> Canadians and NICE use the 'atypical'' description in relation to
> variable
> decelerations:
>
> SOGC
> Atypical:
> Deceleration to < 70 bpm
> Loss of variability in the baseline and trough of decal Biphasic
> deceleration Prolonged secondary deceleration (post deceleration smooth
> overshoot > 20bpm increase and lasting > 20secs Slow return to baseline
> Continuation of baseline at lower level to the prior deceleration
> Presence of fetal tachycardia
>
> And NICE, 2001
> Atypical variable decelerations Variable decelerations with any of the
> following additional
> components:
> i. loss of primary or secondary rise in baseline rate, ii. slow return
> to baseline FHR after the end of the contraction.
> iii. prolonged
> secondary rise in baseline rate,
> iv. biphasic deceleration,
> v. loss of
> variability during deceleration,
> vi. continuation of baseline rate at
> lower level.
>
>
> I haven't come across a deceleration described as 'typical' - Early and
> Late still in use and we are developing greater understanding of
> Variable and complicated variable decelerations - this is the language I
> think is most acceptable and commonly used
>
> Cheers Robyn Maude
>
> PS: Please email me off the list - I'd love to catch up with you in
> regards to your progress on PhD
>
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive health
> research. [mailto:[log in to unmask]] On Behalf Of
> Longworth,Mary Kathleen
> Sent: Thursday, 12 August 2010 19:55
> To: [log in to unmask]
> Subject: Late decelerations
>
> Would be grateful for some advice for anyone who has had to address this
> issue themselves.
> Recently I have been involved with a debate as to whether midwives
> should still be referring to late and early decelerations when
> interpreting CTG tracings. There are some individuals who now refer to
> early and late decelerations as typical and atypical decelerations.
> Just wondered whether the use of typical and atypical decelerations are
> now used elsewhere to replace 'earlys' and 'lates'.
> Thanks
> Mary
> --
> Mary Longworth
> Midwifery Lecturer
> Fron Heulog
> School of Health Care Sciences
> Friddoedd Road
> Bangor
> [log in to unmask]
> Tel No. 01248 383158
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