EFHR Flashcards
Category II
Indeterminate
Tachy or Brady
Minimal, marked or absent variability
Cannot induce accels
Episodic decels
Category I
Normal
FHR 110-160
Moderate variability
No late or variable decels
Maybe yes or no on early decels and any accels
Category III
Abnormal
Absent variability +
- recurrent late decels
- recurrent variable decels
- Brady >10 minutes
- Sinusoidal pattern for 20 minutes
Sinusoidal pattern
A smooth undulating FHR that often result in mobidity
Variable Decel
When they need to be watched
Watch out for:
- Repetitive or deep
- slow return to baseline
- associated with minimal variability
Variable decels
What it can mean
- cord compression
- cord prolapse
IntraUterine Ressucitation
Immediate interventions
5 in order
Pt onto left side 8-10l O2 D/C oxy 500ml bolus NST Notify phys.
Cause of fetal metabolic acidosis
A disruption in flow of O2 to fetus. Causes anaerobic respiration which produces a build up of lactic acid. When buffers are exhausted, academia occurs.
Results of fetal metabolic acidosis
The increased H+ causes decreased peripheral vascular smooth muscle contraction–> reduced vascular resistance –> hypotension–> hypoxic-ischemic injury to heart and brain
Leopold’s maneuvers
- Start at uterine Fundus to feel for butt or head
- Use palmar surface of right hand to feel down back
- Using gentle pressure, Palpate presenting part (fetal head if not engaged) determine attitude (flex, extend)
- Out line fetal head to determine degree of engagement
Accel
Parameters
15 X 15 for >32 week GA
10 X 10 for <32 week GA
Periodic Decel
With contractions
Episodic decel
Not with contracitons
Check mark pattern
Fetal seizure/convulsion
Wandering baseline
Further observation required
Possible Neurologic injury/ fetal demise
