FHR (Fetal Heart Rate)
Formal Definition
The fetal heart rate as monitored by electronic fetal monitoring (EFM) or Doppler during labor and antepartum evaluation; normal baseline FHR is 110–160 beats per minute; categorized as Category I (normal), Category II (indeterminate), or Category III (abnormal) based on NICHD criteria.
How It's Used on the Ward
"The FHR looks good" or "baby strip looks reactive" or "non-reassuring fetal heart tones" — the heart rate tracing is the primary real-time assessment of fetal well-being in labor.
Example
""Patient at 39 weeks in active labor: FHR baseline 140s, moderate variability, accelerations present, no decelerations — Category I tracing. Cervix 6 cm, 80% effaced, -1 station. Continue to monitor.""
Clinical Context
FHR monitoring involves baseline rate, variability (absent/minimal/moderate/marked), accelerations, and decelerations (early, variable, late, prolonged). Late decelerations = uteroplacental insufficiency, concerning. Variable decelerations = cord compression, common in active labor, usually benign if transient. Category III (absent variability + late/variable decels or sinusoidal pattern) = requires emergent delivery. ACOG no longer uses "non-reassuring" — replaced by Category I/II/III system.
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