1. Simpson, Kathleen Rice PhD, RNC, FAAN

Article Content

Fetal Monitoring: A Multidisciplinary Approach (6th Edition), by Susan M. Tucker, Lisa A. Miller, and David A. Miller. St Louis, MO: Mosby Elsevier; 2009. 286 pages.


The sixth edition of Mosby's Pocket Guide Series on Fetal Monitoring: A Multidisciplinary Approach has been completely revised and updated on the basis of recent evidence and professional standards and guidelines. The addition of practicing clinicians Lisa Miller, JD, CNM, and David Miller, MD, as coauthors and Tekoa King, MPH, CNM, as a contributor has served this new edition well. A comprehensive review of the literature with practical tips for clinicians on each of the topics covered provides a clear basis for practice when using fetal monitoring during the antepartum period as well as during labor. New fetal monitoring strips, tables, and graphs have been added to the text as an easy guide for the clinician. An extensive reference list follows each chapter. Appendices with sample fetal monitoring strips are very helpful in reinforcing fetal heart rate pattern descriptions.


Five chapters are of particular importance for daily clinical practice. "Evaluation of Uterine Activity," "Pattern Recognition and Interpretation," and "Management of the Intrapartum Fetal Heart Rate Tracing" each include detailed descriptions of current evidence, gaps in evidence, and guidelines for practice. Clinical management algorithms provide visual displays of the concepts discussed. Emerging technologies such as computer analysis of the fetal heart rate pattern and ST segment analysis are included. The chapter "Patient Safety, Risk Management and Documentation" discusses current issues designed to promote safer care for mothers and their infants. Case studies and legal commentary are provided as an adjunct to the basic principles discussed. The chapter "Influence of Gestational Age on Fetal Heart Rate" is quite useful for considering the physiologic characteristics for fetal heart rate patterns as they relate to the preterm and postterm fetus.


This text will be useful to nursing, midwifery, and medical students and resident physicians as well as to experienced clinicians. The level of content presentation is appropriate for both beginners and experts. Beginners will appreciate the practical writing style, and expert clinicians will value the updated information. The pocket size makes it easy to carry the text as a reference while on the clinical unit. While small in comparison with other fetal monitoring texts, the essential material is covered in a thorough manner. Experts in teaching roles may consider recommending this text for their students and/or resident physicians. Experienced clinicians will find the text a concise resource for reviewing updated information and preparing for national certification examinations.


This text was published before the most recent publication from the National Institute of Child Health and Human Development (NICHD) on electronic fetal monitoring.1 As such, the new classification system including categories (I, II, and III) and interpretative descriptions of fetal heart rate patterns (normal, indeterminate, and abnormal) proposed by the NICHD is not included. Nevertheless, the text is practical and easy to use for those who care for women undergoing electronic fetal monitoring.


Kathleen Rice Simpson, PhD, RNC, FAAN


Perinatal Clinical Nurse Specialist. St. John's Mercy Medical Center. St. Louis, Missouri




1. Macones GA, Hankins GDV, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human De-velopment workshop report on electronic fetal monitoring: update on definitions, interpretation and research guidelines. Obstet Gynecol. 2008;112(3):661-666. [Context Link]