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Cardiotocography in midwifery practice
Bartusková, Simona ; Pařízek, Antonín (advisor) ; Přáda, Jan (referee)
The subject matter of this bachelor thesis has been to create a research identifying the knowledge of the CTG interpretation according to FIGO 2015, both in the theoretical field as well as in the framework of practical skills. Cardiotocography is an integral part of midwife daily routine and a useful method to identify and interpret the lack of oxygenation of the fetus. Therefore, it is a great benefit in terms of reducing the prenatal morbidity and mortality. The work aims at the employment of this method in a deeper and more complex way. The theoretical part focuses on the relevant knowledge up to now, the analysis of CTG, on the recommended processes in the evaluation of the antepartal and intrapartal fetal heart rate monitoring (as it puts emphasis mainly on the changes introduced by the new FIGO 2015 recommendations), on the pathophysiology of fetal hypoxia and last but not least on the nursing care of the midwives in pursuance of FHR monitoring. Using the anonymous questionnaires we tested the theoretical knowledge and practical techniques in the interpretation of CTG by the new guidelines at the Clinic of Gynecology and Obstetrics. Three groups of respondents were addressed, female students of 3rd year bachelor studies (Midwife branch of study), midwives working in delivery rooms and young...
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Cardiotocography in midwifery practice
Bartusková, Simona ; Pařízek, Antonín (advisor) ; Přáda, Jan (referee)
The subject matter of this bachelor thesis has been to create a research identifying the knowledge of the CTG interpretation according to FIGO 2015, both in the theoretical field as well as in the framework of practical skills. Cardiotocography is an integral part of midwife daily routine and a useful method to identify and interpret the lack of oxygenation of the fetus. Therefore, it is a great benefit in terms of reducing the prenatal morbidity and mortality. The work aims at the employment of this method in a deeper and more complex way. The theoretical part focuses on the relevant knowledge up to now, the analysis of CTG, on the recommended processes in the evaluation of the antepartal and intrapartal fetal heart rate monitoring (as it puts emphasis mainly on the changes introduced by the new FIGO 2015 recommendations), on the pathophysiology of fetal hypoxia and last but not least on the nursing care of the midwives in pursuance of FHR monitoring. Using the anonymous questionnaires we tested the theoretical knowledge and practical techniques in the interpretation of CTG by the new guidelines at the Clinic of Gynecology and Obstetrics. Three groups of respondents were addressed, female students of 3rd year bachelor studies (Midwife branch of study), midwives working in delivery rooms and young...
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Monitoring of the status of the fetus during delivery by midwife
SVOBODOVÁ, Jana
This bachelor thesis deals with the fetal health monitoring performed by a midwife during childbirth. The thesis is divided into two parts: theoretical and practical application. In the theoretical part I study the history of the fetal monitoring, compare the methods of the monitoring that were used in the past and I also present the development of the methods that are applied these days. The next chapter is focused on the auscultation of the heart sound, using stethoscope. Despite its limitations, this method is still widely utilized to specify the approximate health condition of the fetus. In the following chapter, I thoroughly deal with the technical means of recording the fetal heartbeat called the cardiotocography (CTG). In this chapter I also describe the principle of this method, particular heart-beat phenomena that can occur and the overall assessment of the cardiotocograph. The next chapter is aimed to study the selective methods that are always connected with the cardiotocography. First, I cover the intrapartum fetal pulse oximetry (IFPO), its principles and the values of the oxygen saturation (SpO2) during childbirth. Next, I present the ST waveform analysis of fetal electrocardiogram (STAN). Even in this chapter I first describe the principle of the method, then its application and finally, the conditions that have to be met for its usage. In the penultimate chapter, I deal with the nursing care. This chapter is focused on the nursing care at the fetal monitoring during the I. and II. stages of labour, during the intermittent and continuous monitoring and it is needless to say that the midwife´s reactions during the monitoring are also added. Finally, I deal with the fact of how the fetal monitoring during childbirth is viewed by lay people. The practical application part of the thesis is aimed at the fact of how women perceive the monitoring of their child during childbirth. One objective was set for this research. The goal was to find out how women perceive the fetal monitoring. Based on the goal of the thesis, three research questions arose. The first one was: What are the women´s feelings during the monitoring? The second research question dealt with the fact whether the women trusted the midwife in the process of monitoring. The last research question was supposed to address the issue of whether the women viewed the monitoring as restrictive. To gather the needed data, a qualitative research was applied, using semi-structured interviews. The research was carried out in the Hospital of České Budějovice a.s., in the puerperium department, interviewing the women one day after either a vaginal birth or an unplanned operative birth in the month of April in 2013. I based my research on a random sample of nine women. From the data collected, all three research questions were answered. The research shows that the most common feelings of the women during the fetal monitoring were calmness and the certainty that their child was all right. By contrast, the prevailing negative feelings were uneasiness, uncertainty and even fear. Next, all the female respondents said that they had trusted the midwife and mainly because of their professional and individual approach that the midwives had applied towards them. Moreover, I discovered that the women whose fetus was being monitored intermittently didn?t perceive any restrictions. One of the women whose fetus was being monitored continuously said that she had felt restricted to a certain extent and mainly in the freedom of movement. The results show that women view the monitoring in a positive way, mainly as a valuable source of information about their children and their current health.
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Women´s in childbed attitude towards cardiotocographical fetal monitoring during childbirth
PAPÍRNÍKOVÁ, Petra
Cardiotocography is a noninvasive method providing information on the condition of the fetus during pregnancy and childbirth. Fetal monitoring has become standard in obstetric care for pregnant women and mothers. The procedures recommended by the Czech Gynecological-Obstetrical Society determine indications of the use of cardiotocography and state rules of how to interpret the results of the method. During physiological childbirth the mother can be observed intermittently, i.e. at regular intervals according to the practice of the specific obstetric department. Pathological delivery, such as breech delivery, delivery of a hypotrofic fetus, fetus with a nonphysiological CTG record, should be monitored continuously. External fetal heart sounds scanning may bring mother some unpleasant restrictions in movement and positioning. When medical staff show preference in observing data obtained by monitoring, it may make the mother fear about the fetus´ condition or raise presumption that midwives do not adequately meet her own needs during the delivery. Nursing care of mothers during cardiotocographical scanning is very specific because a midwife provides care to two subjects - the mother and the child. According to scarce literature on this subject mothers{\crq} in bed attitudes toward cardiotocography vary from the positive view that monitoring protects the fetus and ensures its health to negative feelings of discomfort, limitations, pointless medialization of the natural process, medical personnel distraction and rejection of medical examination. Czech studies, however, have never been conducted and modern literature on this topic does not exist. The research was conducted by the prospective quantitative research using questionnaires. The questionnaires were anonymous and contained 26 questions, 23 of which were closed, 1 was semi-closed and 2 were open. The total number of questionnaires distributed was 101, the target respondents were women in confinement in the Gynecological-Obstetrical clinic of. 1. LF UK a VFN in Praque. The research database was composed of women who were 2 or 3 days after delivery, women with elective Caesarean section were not included into the research. The aim of the research was to learn women{\crq}s in childbed attitude toward cardiotocographical fetal monitoring during childbirth. Three hypotheses were stated: Hypothesis 1 assumes that mothers consider cardiotocographical fetal monitoring to be a source of information on the child condition, and this hypothesis was confirmed. Hypothesis 2 assumes that cardiotocographical fetal monitoring during childbirth restricts the mother{\crq}s movement and relief positioning, and this was confirmed by the research. Hypothesis 3 raises the presumption that there is a lack of valid information provided to mothers on cardiotocography, interpretation of CTG records and their relevance. This hypothesis was confirmed by the research. The women{\crq}s in childbed attitude toward cardiotocographical fetal monitoring during childbirth was evaluated and thus objectives of the thesis were met. Holistic approach in nursing care is supposed to ensure that all patients have access to the best possible comfort, comprehensive care and enough information. The conclusions of the research conducted in the Gynecological-Obstetrical clinic imply the need to improve communication and the flow of information from medical staff to women in childbed and technical possibility of CTG recorders.
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