Antenatal Monitoring Flashcards
Guidance for kick counts?
10 in 2 hours
When do kick counts peak?
9pm-1am
What is a decrease in fetal movement a sign of?
Hypoxemia
What is normal fetal heart rate?
Tachy?
Brady?
120-160
>160
<110
How long is a baseline
Over 10 minutes
How was the baseline named?
In increments of five
What is absent variability?
Zero bpm and a straight line
What is minimal variability
1 to 5 bpm In the baseline
What is moderate variability
5 to 25 bpm in the baseline
What is marked variability
Greater than 25 bpm in the baseline
What is an acceleration at greater than 32 weeks gestational age
15 bpm above baseline for 15 seconds in duration
What is an a celebration at lesson 32 weeks gestational age
10 bpm for a 10 second duration
What is a prolonged acceleration
Greater than two minutes but less than 10 minutes
What is a baseline change
Greater than 10 minutes
What is an early deceleration
It mirrors the contraction and starts and ends with a contraction
What is an early deceleration a sign of
Had compression and a vagal response
What is a variable deceleration
V or W shaped
that may or may not be associated with a contraction
Less than 30 seconds to nadir
What does a variable deceleration show
Partial cord occlusion leads to a decrease in venous return which causes
baroreceptor mediated acceleration in HR → Hypertension and decreased arterial
oxygen tension
Cord compression
What is a late deceleration
Starts after a contraction and ends after a contraction
What does a late deceleration mean
Fetus vasoconstricts → baroreceptor response → decrease in HR
Utero-placental insufficiency
Hypertonus and hypotension
What are the interventions for recurrent variable decelerations
Side to side positioning knee to chest position IVF bolus turn off the oxytocin 02 by facemask tocolytics amnioinfusion
Describe the contraction pattern in minutes
q3 to 5 minutes
Quiet or none
Irritable
What does tocometry measure
The timing of contractions
What do you need to have a place to measure contraction strength
IUPC
How many Montevideo units is an adequate contraction
Greater than 200
What is tachysystole
More than five contractions in 10 minutes
How do you treat tachysystole
Terbutaline
What is a reactive NST
<32 Weeks - 2 accels of 10 beats/minute above baseline for 10 seconds duration
> 32 weeks - 2 accels 15 beats/minute above baseline for 15 seconds duration
Do this for 20 minutes
What is the most common cause of a non-reactive NST
Fetal inactivity or feet of sleep
Next step if NST is non-reactive after 40 minutes
BPP
What is a contraction stress test and how is it done
Place mother in semi Fowler’s position and stimulate contractions
3 contractions in a 10 minute period lasting 40-60
seconds are stimulated
What is a negative contractions stress test
What is a positive contraction stress test
What is an unsatisfactory contraction stress test
No late or variable decelerations
Late decelerations with at least half of the contractions
Lesson three contractions in 10 minutes
When should you avoid a contraction stress test
Placenta previa or a previous classical cesarian
What does a biophysical profile show And how long does it last
Fetal acid-base status and intact CNS
Can last up to 30 minutes
How is the BPP scored
Two points for each category max of 10
Name all of the categories in the BPP
Gross body movements: Three body movements in 30 minutes
Fetal Tone: One episode of extension with return to flexion
Amniotic fluid volume: A pocket that is 2 x 2
Fetal breathing: One episode of more than 30 seconds
A reactive NST
How to manage a score of eight or 10
Repeat at weekly or biweekly intervals
What to do with a score of six
It greater than 36 weeks repeat in 4 to 6 hours. Deliver if oligohydramnios
What to do with the score of four
If >36 weeks, deliver.
If <32 weeks, repeat
score.
What to do with a score of 0 to 2
Extend to 120 minutes deliver if persistent
What is a modified BPP
It is a reactive NST and then AFV with a 2x2 pocket
