1F - Intrapartum Fetal Monitoring Flashcards
Intrapartum monitoring occurs during what time in pregnancy?
A patient is already in labor
Antepartum monitoring occurs during what time in pregnancy?
During prenatal checkups especially for high risk patients
What test assesses the CNS status of the baby?
Biophysical profile
What test assesses the cardiovascular status of the baby?
Doppler Velocimetry
Who proposed that listening to the heartbeat of the fetus would be clinically useful in differentiating fetal compromise from variations in fetal heart rate?
De Kergeradee
How many montevideo units indicates that the mother is already in labor?
200
What is the normal uterine activity?
<5 contractions in 10 minutes
What is tachysystole?
> 5 contractions in 10 minutes
What do we call tachysystole with FHR changes?
Hyperstimulation
what do we call tachysystole without FHR changes?
Hypertonus
What is the normal fetal heart rate?
110-160 bpm
What is a mild contraction based on ctg strip?
A contraction below 40
Variability includes accelerations and decelerations? T or F?
False
Long term variability is seen as oscillatory changes lasting for how many cycles per minute?
3-5 cycles
Good variability indicates compromised fetal heart and CNS functions? T or F?
False
What is normal variability?
5-25
A normal variability is also called as?
Moderate variability
Absent variability indicates fetal compromise? T or F?
True
What is minimal variability?
Less than 5 bpm
If a patient experiences reduced variability with concomitant decelerations, what can be the cause?
Fetal hypoxia
What is the single most reliable sign of fetal compromise or hypoxia?
Reduced fetal heart rate variability
If the patient has reduced variability without decelerations or rise in FHR, what is the status for hypoxia?
Unlikely
What is considered as pathologic variability?
> 25 bpm for 30 mins
Fetal accelerations should not last more than how many minutes?
10 mins
Define normal fetal accelerations?
15 bpm lasting for more than 15 secs but less than 10 minutes
What is the fetal acceleration for preterm babies?
10 bpm lasting for 10 secs
Define prolonged acceleration?
Accelerations lasting for more than 2 mins but less than 10 mins
What do you call a fetal heart rate change of more than 10 mins?
Baseline change
Bradycardia or tachycardia
Early deceleration is caused by?
Fetal head compression due to contraction
The lowest point of deceleration in early deceleration occurs when?
At the peak of contraction
What is the cause of late decelerations?
Uteroplacental insufficiency
When does the lowest point of late decelerations occur in the ctg strip?
After the peak of contractions
A strong indicator of uteroplacental insufficiency is late decelerations together with? (2)
No accelerations and reduced variability
Variable decelerations are secondary to what condition?
Umbilical cord compression
Define variable decelerations?
Abrupt onset to the lowest point within <30 secs, more than 15 bpm lasting >15 secs but <2 mins
Variable decelerations may be associated with hypoxia when it exhibits with? (3)
U shape component
Reduced variability
Lasting more than 3 mins
Variable decelerations occur as decelerations and accelerations in what order?
acceleration - deceleration - acceleration
Prolonged decelerations occur for how many minutes?
More than 2 minutes but less than 10 minutes
Prolonged decelerations is associated with?
Acute fetal hypoxia and acidosis
When can sinusoidal pattern be observed in CTG? (4)
Fetomaternal hemorrhage
Rh isoimmunization
Ruptured vasa previa
Twin twin transfusion
Severe fetal anemia
What pattern in CTG reflects complete loss of autonomic nervous system control due to hypoxia which can be seen as loss of beat to beat variability?
sinusoidal pattern
