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
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Tel No. 01248 383158
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