EFHR

Question 0

Category II

Indeterminate

Answer 0

Tachy or Brady
Minimal, marked or absent variability
Cannot induce accels
Episodic decels

Question 1

Category I

Normal

Answer 1

FHR 110-160
Moderate variability
No late or variable decels
Maybe yes or no on early decels and any accels

Question 2

Category III

Abnormal

Answer 2

Absent variability +

• recurrent late decels
• recurrent variable decels
• Brady >10 minutes
• Sinusoidal pattern for 20 minutes

Question 3

Sinusoidal pattern

Answer 3

A smooth undulating FHR that often result in mobidity

Question 4

Variable Decel

When they need to be watched

Answer 4

Watch out for:

• Repetitive or deep
• slow return to baseline
• associated with minimal variability

Question 5

Variable decels

What it can mean

Answer 5

• cord compression

- cord prolapse

Question 6

IntraUterine Ressucitation
Immediate interventions
5 in order

Answer 6

Pt onto left side
8-10l O2
D/C oxy
500ml bolus NST
Notify phys.

Question 7

Cause of fetal metabolic acidosis

Answer 7

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.

Question 8

Results of fetal metabolic acidosis

Answer 8

The increased H+ causes decreased peripheral vascular smooth muscle contraction–> reduced vascular resistance –> hypotension–> hypoxic-ischemic injury to heart and brain

Question 9

Leopold’s maneuvers

Answer 9

1. Start at uterine Fundus to feel for butt or head
2. Use palmar surface of right hand to feel down back
3. Using gentle pressure, Palpate presenting part (fetal head if not engaged) determine attitude (flex, extend)
4. Out line fetal head to determine degree of engagement

Question 10

Accel

Parameters

Answer 10

15 X 15 for >32 week GA

10 X 10 for <32 week GA

Question 11

Periodic Decel

Answer 11

With contractions

Question 12

Episodic decel

Answer 12

Not with contracitons

Question 13

Check mark pattern

Answer 13

Fetal seizure/convulsion

Question 14

Wandering baseline

Answer 14

Further observation required

Possible Neurologic injury/ fetal demise

Question 15

Which patters reflect interruption in O2 transfer to fetus?

Answer 15

Variable, late and prolonged decels

Question 16

Variable decels

Parameters

Answer 16

ABRUPT

Nadir <2 minutes

Question 17

Recurrent decels

Answer 17

Occur with >50% of UC, over 20 minutes

Question 18

Intermittent decels

Answer 18

Occur with <50% of UC

Question 19

Tachysystole

Answer 19

<5 contractions in 10 minutes

Question 20

Prolonged accel

Answer 20

Longer than 2 minutes

Question 21

Late Decel means?

Answer 21

Maternal hypotension if variability is good.
Reduced placental exchange
Tachysystole
Maternal hypoxemia
All of these things will cause a lack of O2 to get to baby, if placenta is not sufficient, baby cannot compensate.