8/26 Lecture Flashcards
What does the acronym of NR FHR mean?
Non reassuring Fetal Heart Rate
What provides oxygen and nutrients to the fetus?
Umbilical vein
What receives CO2 and waste from the fetus?
Umbilical artery
If fetal hypoxia continues what can happen?
Metabolic acidosis
Damage to vital organs
Accumulation of lactic acid can lead to birth asphyxia
Permanent brain damage may result
If the baby has respiratory difficulties, lack of tone, subnormal consciousness, seizures, what do you suspect?
Neonatal encephalopathy
What type of cerebral palsy is associated with AP or IP asphyxia (ACOG say majority IP)
Spastic CP
What type of cerebral palsy is more related to genetics?
Dyskinetic or ataxic CP
What is a FSE?
Fetal scalp electrode
Used to monitor baby pulse rate
What is normal baseline rate for baby?
120-160
What is fetal bardycardia?
80-100 (if persists this is an ominous sign)
What is fetal tachycardia?
Above 160
What is a common reason for fetal tachycardia?
Chorioamnionitis
Chorion faces who?
Mom
Amnion faces who?
Baby
What are 2 common side effects of epidurals?
Fevers can lead to tachy in the baby
maternal hypotension
What is gentamycin toxic to?
The kidneys
Why is heart rate variability important?
shows that there is both parasympathetic and sympathetic control
Moderate variability (adequate oxygenation) is variability of how many bpms?
6-25 bpms
What is marked variability?
> 25 bpm
What is nonreassuring FHR variability?
Absent
What is minimal feta heart rate variability (concerning, or baby could be asleep)
<6 bpm
What is early decelerations?
Occurs early with UCs. can be due to head compressions, physiologic
If late declarations are persistent, what do you want to think?
Uteroplacental insufficiency (which can lead to fetal hypoxia)
What do variable deceleration indicate usually?
Umbilical cord compression
How many babies are born with a cord around their neck?
1/3 of babies
If there are persistent and deep FHR changes what can be done?
Amniofusion may relieve cord compression
What category is reassuring for FHR?
Category I
What category is worrisome with absent variability, recurrent late or variable decels, bradycardia.
Category III
What category for FHR is concerning?
Category II
What is the most used test where you rub the babies’ head and the fetal heart rate increases.
Fetal scalp stimulation. Indicates that pH is about 7.2
What does a tocolytic agent do?
Stop contractions for a moment, allows baby to get more oxygen
What is the most common thing used to check fetal well being?
Non-stress test (NST)
What do you want to happen in the non-stress test?
Baby to move twice within 15 minutes and both times the HR increases 15 above baseline
What is thick, black, tarry substance in the fetal GI tract? Mixture of lanugo, vernix, bile, skin cells.
Meconium
What is a sign of fetal stress in terms of amniotic fluid?
MSAF- Meconium-stained amniotic fluid (looks like pea soup)
What is included in meconium aspiration syndrome (MAS)?
Pneumonitis
Pneumothorax
Pulmonary HTN
How is meconium managed at birth?
Don’t suction
Observation if baby is vigorous
look down airway with laryngoscope
What should be done with a vigorous baby after it is born?
Dried off and placed on the mother’s abdomen skin to skin
Why is putting the baby on the mom’s skin better?
Allows baby to stabilize- respirations, heart rate, glucose levels
What is the minimal amount of time that baby should be left skin to skin?
1-2 hours
what is a point system to score neuromuscular and physical maturity. Helps determine gestational age.
Ballard score
Should alcohol or ointments be used when the cord is cut?
No, inhibits drying and falling off
What is an opthalmic ointment used to treat gonorrhea in the birth canal?
Erythromycin
When should the baby void and have a bowel movement within?
24 hours
What type babies is hyperbilirubinemia more common in?
Near term (35-37 weeks)
What is a drug that can be given for severe respiratory depression?
Narcan
What cord gas will always look better?
Venous
an UA pH less than what is the beginning of acidemia?
<7.20
What can acidemia turn into
Acidosis then asphyxia
What is responsible for neonatal mortality?
Preterm birth (Less than 37 weeks gestation)
What is early pre-term labor?
23-26 weeks
What cause the whole prostaglandin synthesis to be released leading to pre-term labor?
inflammatory cytokines
What is induction of labor before 39 weeks?
Iatrogenic (not allowed electively anymore)
what is the metabolic, active part of the uterus?
Decidual
The signs and symptoms must be ____, predicts per-term labor.
Rhythmic
Where does fetal fibronectin collect?
Posterior fornix of the women’s cervix.
What does the TVUS allow you to see?
Funneling. (amniotic sac pushing in on cervix)
What other condition is associated w/ pre-term labor?
Bacterial vaginosis (BV)
what is given for women who are at risk of pre-term labor
17- alpha-hydroxyprogesterone
What weeks gestation should you give corticosteroids to enhance fetal lung maturity preventing RDS?
24-34 weeks
What are some tocolytics?
Magnesium sulfate, nifedipine (earlier)
Indomethacin, terbutaline
What length of the baby with give you an estimate of the gestational age?
Crown- rump length
What is a main reasons for post dates?
Inaccurate estimation of gestational age
What is a syndrome with growth restriction, dehydration, hypoglycemia, RDS? Babie’s skin was peeling, look like old people
Dysmaturity Syndrome
What is where AFI less than 5 cm, can lead to cord compression, placental insufficiency?
Oligohydramnios
