Assessing FHTs on pregnant hospitalized women not on L&D

[kathiecnm]

I am trying to be sure we provide the best perinatal care to all pregnant women who are patients on units other than L&D at our hospital. This especially applies to those 20-24 weeks gestation & further who have a potentaily viable fetus. Currently we request an order for "fetal assessment" from the woman's MD if one is not already given. Our Perinatologists usually follow these women in the hospital, particularly if they have complicated medical problems that could affect the pregnancy & fetus. The L&D nurses have those patients & their surveillance orders on a special board on L&D & the Charge Nurse sees that they are followed & documented in the mother's chart. My question is, does anyone have a better idea & how do you assess FHTs on pregnant women in this category having surgery? Continuous EFM is not possible in surgery, but is obtaining a "reassuring" tracing before & after surgery adequate? An reactive NST may not be possible in this time frame & certainly not with immature gestations. Hope to hear from my sister/brother perinatal nurses on this topic. It's good to learn & share with one another, especially with all the old & new challenges we face these days.

[LightningRN]

For pregnant surgical patients depending on their gestation we typically either dopple FHTs before and after the surgery or get an NST after the surgery. For med-surg patients that happen to be pregnant we usually dopple FHTs Q8 hours or so, depending on the situation of course. If they need more maternal/fetal care than that, they need to be on an Antepartum unit in my opinion.

[HappyNurse2005, RN]

Those patients are often on our antepartum unit, and we take care of them (mixed l&d/antepartum unit here). We've had many med surg type pt's who are pregnant. sickle cell crisis, pneumonia, dka, galbladder removal, ruptured appendix removal, ovarian cyst removal, etc. If it was something more critical, we would take the portable monitor to wherever they were and monitor them-how long would dependon gestational age. 20-24 weeks? probably just heart tones q shift, depending.