Chapter 18 Flashcards
what can cause decreased oxygen supply
Reduction of blood flow through maternal vessels
Reduction in oxygen content in maternal blood
Alterations in fetal circulation
Reduction in blood flow to intervillous space in placenta
what is intermittent auscultation
Listening to fetal heart sounds at periodic intervals to assess FHR
Easy to use, inexpensive, less invasive than EFM
Difficult to perform on women who are obese
Does not provide a permanent record
what is the point of maximum impulse
chest or back
what is the spiral electrode used for
internal monitor for fetal HR
How are spiral electrodes placed
placed in bony part of fetal head , not placed on fontanels, harder to place and stay in place with lots of hair
when are spiral electrodes indicated
If your having trouble pickup baby up or. Heavier mother and not picking baby up, if decels or nonreassuring fetal patterns, internal monitoring is used
what is a intrauterine pressure catheter (IUPC)
Only way to measure intensity of contraction
inserted vaginally , goes up into uterus and picks up pressure that uterus is applying to it,
what is the definition of baseline fetal HR
average rate for 10 min without periodic or episodic changes, periods of marked variability, or segments that vary by more than 25 bpm
must have at least 2 min period to get baseline
what is variability
Described as irregular waves or fluctuations in the baseline FHR of two cycles per minute or greater
what are the types of variability
Absence
Minimal
Moderate
Marked
what is absent variability
No variation in beat to beat changes
Severe anemia
Severe neuro dysfunction
Will deliver baby if not fixed
Something wrong with baby
what is minimal variability
< 5 bpm variation around baseline
Tiny fluctuations in beat to beat changes
Can be okay
baby have sleep cycles up to 90 min
Can occur if opioid medication was given
Wouldn’t be rushing to deliver baby right away
what is moderate variability
6-25 bpm variation around baseline hr
ideal, what we want
normal , reassuring
what is marked variability
> 25 bpm variation
not good
can indicate same type of abnormalities
blood loss, neuro dysfunction , oxygen deprivation
what is a sinusoidal fetal HR pattern
Don’t have any variability
Constant wavelike pattern
Bad, wont see pattern long term and not deliver baby
Common with opioid, but it will be brief and will correct itself
Have to do interventions to see if it fixes
what is fetal tachycardia
HR greater than 160 beats/min for 10 min or more
what is fetal bradycardia
HR less than 110 beats/min for 10 min or more
What are changes in FHR
periodic changes occurring with UCs
Episodic (nonperiodic changes) not associated with UCs
Accelerations - indicate fetal well being
what is normal fetal HR
110-160
what are early decelerations
response to fetal head compression
mirror contractions
Periodic cuz associated with contractions
Peak of contraction mirrors Lowes point of deceleration
what are late decelerations
caused by uteroplacental insufficiency
deceleration begins after peak of contraction not good but if 1 or 2 occur and they correct with intervention then its okay
not corrected = deliver baby
what are variable decelerations
caused by umbilical cord compression
Looks like V, U, W
more abrupt in decline
greater than 30 to the lowest point from baseline
can be hard to tell difference from late decel
think like kinking waterhose
what are prolonged decelerations
these are bad , decrease in HR longer than 2 min , will need to do interventions
What is category 1 EFM
this is normal
Baseline FHR
moderate variability
no late or variable decals
may or may not have early decals
may or may not have accelerations
