Fetal Monitoring of Twins Deborah J. Eganhouse, RN, MA  Journal of Obstetric, Gynecologic & Neonatal Nursing  Volume 21, Issue 1, Pages 17-27 (January 1992) DOI: 10.1111/j.1552-6909.1992.tb01717.x Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 1 Synchronous fetal heart rate tracings have similar frequency and timing of accelerations, baseline oscillations, and periodic changes. Journal of Obstetric, Gynecologic & Neonatal Nursing 1992 21, 17-27DOI: (10.1111/j.1552-6909.1992.tb01717.x) Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 2 Asynchronous tracings have differences in reactivity and long-term variability. Journal of Obstetric, Gynecologic & Neonatal Nursing 1992 21, 17-27DOI: (10.1111/j.1552-6909.1992.tb01717.x) Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 3 Nonstress testing with two different monitors decreases electronic signal interference. For maternal comfort, only two belts are used to position all four transducers. Journal of Obstetric, Gynecologic & Neonatal Nursing 1992 21, 17-27DOI: (10.1111/j.1552-6909.1992.tb01717.x) Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 4 Question marks at the top of the tracing (note arrows) indicate that similar signals are being detected during dual monitoring. Journal of Obstetric, Gynecologic & Neonatal Nursing 1992 21, 17-27DOI: (10.1111/j.1552-6909.1992.tb01717.x) Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 5 During intrapartal monitoring, a single dark fetal heart rate tracing should alert the nurse to readjust the cardiotransducer. Journal of Obstetric, Gynecologic & Neonatal Nursing 1992 21, 17-27DOI: (10.1111/j.1552-6909.1992.tb01717.x) Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 6 After adjustment of the cardiotransducer (see Figure 5), two distinct fetal heart rate tracings are recorded. Journal of Obstetric, Gynecologic & Neonatal Nursing 1992 21, 17-27DOI: (10.1111/j.1552-6909.1992.tb01717.x) Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 7 The first twin is accidentally monitored by spiral electrode and cardiotransducer. Monitor paper with separate scales shows identical fetal heart rate tracings. Journal of Obstetric, Gynecologic & Neonatal Nursing 1992 21, 17-27DOI: (10.1111/j.1552-6909.1992.tb01717.x) Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 8 Readjustment of the ultrasound transducer (see Figure 7) results in two distinct tracings. Journal of Obstetric, Gynecologic & Neonatal Nursing 1992 21, 17-27DOI: (10.1111/j.1552-6909.1992.tb01717.x) Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 9 Nursing care plans should include pertinent information to assist nurses in monitoring twins. FHR: fetal heart rate; U/S: ultrasound. Journal of Obstetric, Gynecologic & Neonatal Nursing 1992 21, 17-27DOI: (10.1111/j.1552-6909.1992.tb01717.x) Copyright © 1992 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions