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OB > Ch 14 Fetal monitoring > Flashcards

Ch 14 Fetal monitoring Flashcards

1
Q

what method of EFM:

  • high risk
  • ptns on oxytocin (induction of labor)
  • epidural
  • NOT home births, birth centers
  • ONLY in patient settings
A

continuous

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2
Q

what method of EFM:

  • ptns who are ambulatory, low risk
  • Can be done w/ doppler if only - FH is required or EFM short strip is only needed
A

intermittent

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3
Q

how long are fetal monitoring strips kept?

A

21 years total

18 + 3 years to file suit

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4
Q

how do you monitor uterine contractions?

A

palpate

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5
Q

ACOG

Reassuring. No further action needed at this time

A

Cat 1

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6
Q

ACOG

Indeterminate. Warrants further observation. → most strips are likely here

A

Cat 2

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7
Q

ACOG

Abnormal. Immediate and prompt intervention required. → delivery within 30 min or DEATH

A

Cat 3

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8
Q

110-160

A

normal fetal hr

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9
Q

Baseline

Must be able to observe a portion of tracing without ___________________ or without variations of </>## bpm

A

Must be able to observe a portion of tracing without periodic/episodic changes or without variations of >25 bpm

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10
Q

Fluctuations or ‘waviness’ of the baseline FHR

A

Variability

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11
Q

amplitude peak to trough UNDETECTABLE

like asystole

A

absent variability

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12
Q

due to meds, fetal sleep cycle, anesthesia

amplitude >undetectable but <5

A

minimal variability

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13
Q

normal variability

amplitude >6 and <25

A

moderate

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14
Q

may be related to hypoxia or fetal seizure activity

amplitude >25

A

marked

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15
Q

what is the predictor of oxygenation and acidosis level of the fetus?

A

variability

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16
Q

Smooth, undulating wave form

Can be indicative of severe fetal anemia or of use of certain types of medications (Stadol) (especially if it goes away in a short pd of time)

A

sinusoidal

17
Q

Transient or sustained fetal heart rate under 110 bpm

Must determine which it is because interventions different

if true - may be cardiac defect
if transient, may be r/t hypoxic event

A

bradycardia

18
Q

Baseline of over 160 bpm for more than 10 minutes

Prolonged accelerations can be confusing-can be caused by fetal movement

True __________ can be caused by maternal and/or fetal infection, maternal meds, illicit drugs

A

tachy

19
Q

most common causes of fetal tachy

A

infection
dehydration
drug abuse

20
Q

what stops uterine contractions, esp b/c they are close together due to oxytocin?

A

terbutaline

21
Q

fetal heart rate changes that occur WITH contractions

A

periodic

22
Q

fetal heart rate changes not associated w/ contractions

A

episodic

23
Q

15 x 15 rule

A

32 weeks, 15 beats above baseline for at least 15 seconds

24
Q

10 x 10 rule

A

<32 weeks criteria for accelration becomes 10 x 10

25
Q

normal, or sign of head compression (cephalopelvic disproportion)

A

early decel

26
Q

occur after contraction

usually b/c of uteroplacental insufficiency

bad sign - no oxygen / cut off oxygen - fetal acidosis / hypoxemia. requires immediate intervention

interventions: position, give mom o2, IVF, stop pitocin, c-section

A

late decel

27
Q

can be with or without contraction; usually transient; don’t let it linger down below

generally V in shape

cause: cord compression
intervention: positioning; amnioinfusion may be indicated if recurrent to provide cushion to prevent cord compression

A

variable decelerations

28
Q

Lasts between 2-10 minutes.

Many causes of disruption to fetal oxygen supply.

Cord compression, pushing, hypotension after epidural, prolonged uteroplacental insufficiency (abruption, tachysystole)

A

prolonged deceleration

29
Q

Predictive of normal acid/base balance

Baseline FHR 110-160 bpm

Baseline variability moderate

Present or absent accelerations

Present or absent early decelerations

No late or variable decelerations

A

cat 1

30
Q

Not predictive of abnormal fetal acid/base status
Fetal tachycardia present
Bradycardia not accompanied by absent baseline variability
Absent baseline variability not accompanied by recurrent decelerations
Minimal or marked variability
Recurrent late decelerations with moderate baseline variability
Recurrent variable decelerations accompanied by minimal or moderate baseline variability. Overshoots or ‘shoulders’
Prolonged decelerations >2 min. but

A

Cat 2

31
Q

Predictive of abnormal fetal acid/base status

Fetal bradycardia

Recurrent late decelerations

Recurrent variable decelerations

Sinusoidal pattern

A

Cat 3

OB (10 decks)

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