Toco monitoring

[elizabethdean082]

I was wondering what is the actual point of toco monitoring, if it really doesn't mean anything. I understand it can be hard to tell if a woman is going in to labor unless the cervix is checked. However I just can't see why they monitor for two hours when it really doesn't mean anything.

[NBSAlvarez]

There are all sort of valid reasons why you would want to do toco monitoring. If you have a patient that is going to be induce, you going to want to know how frequently and how intense her contractions are. You don't want her to contract too much (with the medication) and put her at risk for uterine rupture or cause fetal distress. Taking it a step back, you don't want to give your patient, medication when she is already frequently contracting.

Other reasons would be that you want to see if she is really contracting or see how the fetus reacts to the contractions. Remember decelerations? You want to see if those are related to contractions. I hope this was helpful.

[Alikatz08]

It's definitely important for various reasons. Of course for intensity that would either be via palpation or internal monitoring (ONLY if needed), as the external would only show us frequency and how long they are lasting. If a fetus is having any type of decelerations, it's important to know when they are occurring in relation to the contractions. And as the previous poster stated, it's important to monitor her contractions if medications are to be introduced, etc.

[klone, MSN, RN]

EFM gives us a lot of information. No, of course it doesn't tell us if a woman is in true labor. The important information it gives us is about fetal wellbeing and oxygenation, and how the fetus handles contractions.

If we're triaging a woman for a "labor check" we would not make her sit on the monitor for 2 hours, though. We would get a 20-30 minute strip to check for fetal wellbeing, then we'd tell her to get up and walk around for an hour.

[perfexion, ASN, RN]

You should take an electronic fetal monitoring course. It's more about fetal well being than labor progression. If we didn't monitor contractions and the baby's heart rate randomly dropped 30 beat per minute for 30 seconds, how would we know if the baby was in distress or if the baby's head was just descending into the pelvis? That's a BIG important distinction and it would greatly impact the types of interventions we perform.