This is about cEFM. Don’t be shocked. . I love variability! Who doesn’t love that predictable fetal heart amplitude greater than 5 bpm 😆 throw in some spontaneous accelerations and I am just gleeful!!! That baby is loving life 🤗 . In the instance of absent variability (undetected amplitude) that’s almost a relief as well, because we have clear cut evidence about correlation to poor outcomes when the fetal heart rate amplitude is undetectable 😖 . Minimal variability (<5 BPM) and Marked variability (<2) BPM) are more difficult interpretations 🤧 I wish it was clear cut, and gave us a diagnosis. However, it doesn’t. It’s a snapshot that gives us clues about how we think the baby is doing on the inside. Then we take the evidence, along with other corresponding data, and do what we think is best, based on our best guess about where the baby will be the safest (remaining inside vs. being born) . Everything besides moderate variability is sus 👀 . We want EFM to be something it isn’t. We want EFM to give us more information than it can.. it is only a part of the puzzle and we have to put all the evidence together and make a decision. . This portion of a strip you see was after hours of attempting uterine resuscitation (maternal movement, Food and drink, IV hydration, external stimulation, internal scalp stimulation) and an ultrasound showing a BPP of 4/10 (+breathing +fluid) . The evidence leaned towards moving forward with a non-emergent expedited birth. The APGARS 5/9 (no indication to collect gasses) . I don’t know what placental pathology was, baby discharged home with mom. Nobody knows. Nobody wanted to wait and find out either. A choice was made, and mom is left with the words “you can always try for a VBAC next time” 🥴 . Continuous External Fetal Monitoring in labor. It’s the worst best invention ever. It’s fixed everything and nothing. It’s made it all better and so much worse. . #laboranddeliverynurse #efm #generalelectric