Ch18 Fetal Assessment During Labor (Exam 2, study guide) Flashcards
Average FHR range of 110-160bpm at term as assessed during a 10-minute segment that excludes periodic or episodic changes and periods of marked variability
baseline FHR
Persistent (>10min) baseline FHR <110bpm
bradycardia
visually apparent abrupt or gradual decrease in the FHR of >15bpm below the baseline that lasts >2min but <10min
prolonged decelerations
changes from baseline patterns in FHR that occur with uterine contractions
periodic changes
persistent (>10min) baseline FHR >160bpm
tachycardia
expected irregular fluctuations in the baseline FHR of 2 cycles/min or greater as a result of the interaction of the sympathetic and parasympathetic nervous systems
variability
visually apparent gradual FHR decrease starting with the onset of a contraction in response to fetal head compression
early deceleration
visually apparent gradual FHR decrease after the start of a uterine contraction, usually in response to uteroplacental insufficiency
- the lowest point occurs after the peak of the contraction and baseline rate is not usually regained until the UC is over
late deceleration
visually abrupt FHR decrease any time during a contraction in response to umbilical cord compression
variable deceleration
visually apparent abrupt increase in the FHR of >15bpm above the baseline rate that lasts >15sec with return to baseline <2min from the beginning of the increase
accelerations
changes in FHR from baseline that are not associated with UCs
episodic changes
deficiency of oxygen in the arterial blood
hypoxemia
inadequate supply of oxygen at the cellular level
hypoxia
method of listening to fetal heart sounds at periodic intervals to assess the FHR using a Pinard stethoscope, DeLee-Hillis fetoscope, ultrasound stethoscope, or Doppler
intermittent auscultation
external monitoring instrument that works by reflecting high-frequency sound waves off of the fetal heart and valves to assess and record the FHR pattern
ultrasound transducer
ultrasound transducers are placed over the area of
maximum intensity of FHR after conductive gel is applied to its surface
external monitoring instrument that measures uterine activity transabdominally
tocotransducer
a tocotranducer is placed over the
fundus above the umbilicus
internal monitoring instrument that is attached to the fetal presenting part to assess FHR pattern
spiral electrode
internal monitoring instrument that is solid or fluid filled
- it is inserted into the intrauterine cavity to measure uterine activity
intrauterine pressure catheter (IUPC)
methods of assessment that use digital, sound, or light stimulation to determine the reaction of the FHR
fetal scalp stimulation
and
vibroacoustic stimulation
instillation of room-temperature isotonic fluid (NS or LR) into the uterine cavity if the volume of amniotic fluid is low to relieve intermittent cord compression that results in variable decels and transient fetal hypoxia
amnioinfusion
abnormally small amount of amniotic fluid
oligohydramnios
absence of amniotic fluid
anhydramnios
relaxation of the uterus that can be achieved through the administration of drugs that inhibit uterine contractions
tocolytics
commonly used tocolytic
terbutaline (Brethine)
assessment method used immediately after birth as an adjunct to the Apgar score
- it measures pH, pO2, pCO2, and base deficit or excess of the newborn’s blood
umbilical cord acid-base determination
group of interventions initiated when an abnormal (nonreassuring) FHR pattern is noted to improve uteroplacental perfusion and increase maternal oxygenation and CO
intrauterine resuscitation
