In fetal heart rate monitoring, there are many kinds of curves that indicate fetal hypoxia. Today, Dr. Huang introduced the most common kind of curve chart in the form of a case - the "big horizon". The continued appearance of the "great horizon" is a sign of intrauterine hypoxia in the fetus and a signal for the fetus to call for help.
Pregnant woman Ms. Ma, because of the B ultrasound examination around the neck when she was 37 weeks pregnant, her heart was not steady, so she rented a fetal heart monitor and monitored it every day, which was very reassuring. On January 18th, Ms. Ma had time to do fetal heart rate monitoring at five o'clock in the afternoon, and the monitoring results came out, the score was only 6 points, the fetal heart rate curve only fluctuated slightly, close to the big horizon, and the fetal heart base line was also high, more than 160bpm. At this time, the bud suggests that the fetus may have hypoxia, and it is recommended that pregnant women retest as soon as possible for a monitoring or immediate medical treatment. When Ms. Ma saw the results of the report, although she was a little nervous, she did not plan to go to the hospital.
After half an hour, Ms. Ma was uneasy and retested a fetal heart rate monitoring. The guardianship score is 7 points, and the curve is a large flat line. Xi Ya once again reminded pregnant women to seek medical treatment as soon as possible. However, Ms. Ma still has no intention of going to the hospital at this moment, and still has a "fluke" mentality.
After more than an hour of this, Ms. Ma picked up the Xiya fetal heart rate monitor again and did a fetal heart rate monitoring, measured the monitoring for 13 minutes, and the curve was the same as before, or a large horizon. Ms. Ma realized the danger and immediately rushed to the hospital with her family.
After arriving at the hospital, the doctor gave oxygen for two hours, continuous fetal heart rate monitoring, the monitoring result was also "non-responsive", immediate emergency caesarean section, the baby was diagnosed with "intrauterine distress" after birth, and immediately transferred to the neonatal intensive care unit for intervention and treatment. After the operation, the doctor said in a serious tone: "It is good to come to the hospital early, otherwise it is likely that the baby will be gone."
Later, Ms. Ma and her friends recalled this incident and could not help but feel some regret in their hearts. If Xi Bud's first fetal heart rate monitoring suggests hypoxia, she can go to the hospital for the first time, perhaps it can reduce the time of fetal hypoxia, or the baby does not need to go to the neonatal intensive care unit, or the mother and child will not be separated.
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What does the case mean by "grand horizon"? Sometimes, pregnant mothers actually think that the big horizon represents "the baby's fetal heart rate is very stable", which is a good performance. In fact, clinicians are very concerned about the baseline variation (amplitude variation).
The fetal heart rate curve is straight, medically representing the disappearance of amplitude variation. Baseline amplitude variation refers to changes in peak-to-trough fetal heart rate per minute, with a normal range of 6-30 bpm, and monitoring shows a bumpy and fluctuating curve. When the baseline amplitude fluctuation ≤ 5bpm, it is a small variation. Persistent amplitude variation is small, and even the fluctuations disappear, indicating that the baby's state is not good, and it is very likely that there will be intrauterine distress or even metabolic acidosis of the fetus. What needs to be noted here is the word "continuous".
Q: How many segments of the 20-minute curve are relatively flat, does that mean there is a problem?
The answer is no. Interpreting a fetal heart rate monitoring map is to look at the overall curve response of 20 minutes, not to interpret it in segments. When the baby is not moving much, the curve will show a certain gentle curve.
Q: Why did the doctor ask you to take another test when the level was measured?
A: There is a kind of "big horizon", which is a false positive phenomenon, mostly due to the fetus being in a sleeping state, resulting in a flat fetal heart rate curve at this moment, and it is not really hypoxia. The fetus generally wakes up for 20-40 minutes, that is, the baby sleeps for a while, wakes up for a while, and then enters the sleep cycle. Pregnant mothers try to avoid monitoring periods that are easy to cause false positive results in the process of fetal heart rate monitoring, so that the fetal heart rate monitoring curve can more realistically show the true state of the fetus.
If the baby is sleeping at the time of the test, there is no obvious fetal movement, this time you can then test 1-2 times to monitor it. At this time, the baby wakes up, there is fetal movement, if the measured results are normal, it means that the fetus is in good condition; if the fetus is moving, it is still a flat line, then consider the lack of oxygen in the fetus, and should seek medical treatment in time.
Remind pregnant mothers: Under normal circumstances, the fetus will not last for more than 60 minutes of sleep, if you continue to monitor 1-2 times, the fetus still does not move much, and the curve is also a large horizon, you also need to seek medical treatment in time, do not consider the fetal sleep state.
As shown in the figure below, the results of the first test are flat, and the results of the retest after ten minutes are normal, which can explain the curve of the first flat as "the baby's sleeping state", not hypoxia, and no need to seek medical treatment.
Xiya reminds you: pregnant mothers at home fetal heart rate monitoring, must choose the fetus awake when there is fetal movement monitoring, if the continuous monitoring shows a "big horizon", you should consult Xiya medical consultant in time, and follow the advice to retest or seek medical treatment in time, so as to avoid the fetus in danger.