fetal well being

assessment of fetal welbeing during labour
first dont forget features or criteria of normal labour(memorization)
Features of normal labour:
1. Spontaneous onset at 37–42 weeks’ gestation.
2. Singleton pregnancy.
3. Cephalic vertex presentation.
4. No artificial interventions.
5. Cervical dilatation of at least 1 cm every 2 hours in the active phase of first stage.
6. Active second stage no more than 2 hours in primiparous and 60 minutes in multiparous woman.
7. Spontaneous vaginal delivery.
8. Third stage lasting no more than 30 minutes with active management or 60 minutes with physiologic management

events during labour
During labouruterine perfusion is dramatically reduced during each contraction, and fetal assessment is very important because labor is very stressful condition.
the use of operative delivery for ‘non-reassuring fetal status’remains to occur every day in delivery wards.
The aim of monitoring:
The aim of monitoring of fetal well-being during labouris to prevent birth asphyxia and so reduce perinatalmortality, neonatal intensive care unit (NICU) admissions at term, umbilical cord acidosis (pH <7.2) and base deficit >12 mmol/L, low Apgarscores, neonatal hypoxic ischaemic encephalopathy at term,and long-term handicap.

Arterial pH Hypoxaemiawill result when gas exchange across the placenta is impaired, with a gradual fetal accumulation of CO2. This leads to fetal acidaemia, which can be detected by analyzing fetal capillary or neonatal arterial pH. The lower limit of normal fetal or neonatal pH is 7.20. The type of acidosis is also important In a respiratory acidosis, the PCO2 is elevated but the base excess is normal, a condition that will be easily resolved with the onset of neonatal respiration and gas exchange. Metabolic acidosis is associated with a transition to anaerobic metabolism and an accumulation of acids, such as lactate. It is defined by a base deficit >12 mmol/L and is a marker of moderate to severe neonatal morbidity.
* Methods of assessing FHR:
1-intermittent auscultation. 2-Continuous electronic fetal monitoring