It is not uncommon for a pregnant patient to develop a surgical condition or to be placed in an intensive care unit for a critical illness. Trauma, asthma, appendicitis, and inflammatory bowel disease are just a few of the conditions that commonly cause women to seek urgent medical and surgical care.
Most experts consider the fetus to be viable at 24 weeks of gestation. At this time, the surgeon
should direct care to both the mother and the unborn child. While the ultimate responsibility is to the life and health of the mother, surgeons and critical care physicians should be able to recognize signs of fetal distress and be able to rapidly collaborate with an obstetrician to determine optimal therapy.
One of the most widely available ways to monitor the status of the fetus is with a fetal monitor. This consists of two probes. One probe uses a sensor to record the duration and frequency of contractions of the uterus. A second probe uses ultrasound or sound-wave technology to record the fetal heart rate.
The fetal monitor is most accurate after 32 weeks of gestation. Worrisome signs of fetal distress include a rapid fetal heart rate (tachycardia), loss of heart rate variability, and late fetal heart rate decelerations.
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