Electronic Fetal Monitoring and Fetal Assessment BB

Question 1

Indications for EFM

Answer 1

• Hx stillbirth
• Preg Complications
• Induced Labor
• Preterm Labor
• Nonreassuring fetal status
• Meconium staining of amniotic fluid

Question 2

Methods of fetal monitoring

Answer 2

• Intermittent auscultation by doppler (fetascope)
• Continuous external monitoring ( tocodynamometer “Toco + US”)
• continuous internal monitoring (spiral electrode placed on baby scalp)

Question 3

Criteria for Internal monitoring

Answer 3

• Ruptured Amniotic membrane
• Cervix dilated 2 cm
• presenting part down against cervix

Question 4

Baseline fetal; HR

Answer 4

120-160 BPM

Question 5

What is a cardiac marker of fetal wellbeing?

Answer 5

Accelerations of 15 BPM for 15 seconds

Question 6

FHR Decelerations

Answer 6

Early -> Head compression; No intervention

Variable -> Cord compression; Variable interventions

Late (After end of contraction): Uteroplacental insufficiency -> Ominous; needs immediate attention

Question 7

Nursing Care for FHR Decelerations

Answer 7

• Stop Pitocin
• Reposition
• INC Rate of mainlineIV
• Administer O2 by mask 10L/min
• Terbutaline Sub-q
• Notify primary
• if does not improve, prepare immediate delivery

Question 8

Fetal Scalp stimulation

Answer 8

Looking for variable accelerations for well=being

- Gently stroke/massage fetal scalp during vaginal exam

Question 9

Fetal Scalp Blood Sampling

Answer 9

• Test Fetal O2
• Reqs rupture of membranes
• ACidotic if pH<7.2

Question 10

Cord Blood Analysis Criteria + purpose

Answer 10

• significant abnormal FHR
• Meconium stained amniote
• Infant depressed at birth
• tests umbilical cord blood for acidosis/hypoxia

Question 11

Montevideo Units

Answer 11

• Uterine contraction intensity during labor
• Measured via internal pressure monitor
• > 200 req’d for adequate labor/dilation/effacement