This tool is designed for educational purposes and is adapted from the SOGC 2020 Fetal Health Surveillance (FHS) guidelines. It can make mistakes. Clinical judgment is paramount.
Not a Diagnostic Tool: This is NOT a clinical diagnostic tool or a medical device. It is an educational tool only.
User Responsibility: The user assumes all responsibility for clinical interpretation, diagnosis, and management plans.
Logic Limitations: Algorithmic logic may not capture all clinical nuances (e.g., monitor signal quality, palpation correlation, or evolving clinical pictures).
No Liability: The creator explicitly disclaims all liability for any damages, medical errors, or adverse outcomes resulting from the use of this tool.
Institutional Protocol: This tool does not replace institutional policy or professional clinical training.
By clicking "Begin," you acknowledge these limitations and assume full responsibility for the clinical application of any output.
Reminder: TOCO does not measure contraction intensity or resting tone. Palpation is required to verify uterine tone and contraction strength.
Is the contraction tracing adequate and aligns with palpation?
Action Required: Take steps to resolve the discrepancy as per institutional protocol. This may include adjusting the TOCO, replacing the monitor, or using internal monitoring.
If the TOCO remains unreliable, uterine activity must be assessed via manual palpation.
Are there greater than 5 contractions in 10 minutes, averaged over 30 minutes?
Contraction Peak Intensity (IUPC)
Are there any contractions with a peak ≥ 75 mmHg (not applicable in the second stage)?
Resting Tone (IUPC)
Is the resting tone ≥ 25 mmHg?
Contraction Duration
Are there any contractions lasting > 90 seconds in duration?
Coupling or Tripling Contractions
Are there any contractions that are coupling or tripling (without returning to a soft uterine tone in between) that have a total duration > 90 seconds?
Resting Tone Duration
Is there ≥ 30 seconds of resting tone between all contractions?
Clinical Presentation
Is the patient in constant pain with no periods of relief?
⚠️ Reminder:
Tachysystole can reduce placental blood flow and may impact fetal oxygenation status over time, regardless of the current fetal heart rate classification.