Fetal Adaption Flashcards
How many vein and artery
2 arteries and 1 vein
What does the vein carry
Oxygenated blood
What does the arteries carry
Deoxygenated blood
What is the types of monitoring?
Auscultation/Intermittent Auscultation
External Fetal Monitoring
Internal Fetal Monitoring
Tocotransducer and ultrasound transducer are
External Monitoring
Internal Scalp Electrode and Intrauterine Pressure Catheter are
Internal Monitoring
Frequency
Beginning of one cxt to the beginning of the next cxt
What are frequency measured by
Minutes
Duration
Beginning of the contraction to the end of the contraction
What is Duration measured by
Secs
Intensity
Strong of the cxt
How is intensity is measured by
Mild, Moderate, Strong
Resting Tone
Palpation of uterus when there is no cxt is taking place
Why knowing the resting tone important
Allows the fetus to recover and have oxygen exchanged occur
Tachycardia
FHR >160 lasting greater than 10 mins
Tachycardia causes
early fetal hypoxemia, maternal dehydration, drug induced, intraamniotic infection, maternal hyperthyroidism, fetal anemia, fetal heart failure, fetal cardiac dysrhythmias
Bradycardia
FHR <110 BPM greater than 10 mins
Bradycardia causes
Late fetal hypoxemia, Drug induced, prolonged cord compression, fetal congenital heart block, maternal hypothermia, prolonged maternal hypogylcemia,
Absent Variability
undetectable FHR
Minimal Variability
</= 5bpm
Moderate Variability
6-25 bpm
Marked Variability
> /= 25
Periodic
Occurs w/ cxt
Episodic
non associated with cxt
Etiology of Accelerations
Fetal movement
Vaginal exam
Internal Scalp electrode application
Fetal Scalp Stimulation
Fetal reaction to external sounds or stimulations
Breech presentation
Uterine contractions
Partial cord compression of the umbilical VEIN resulting in decreased fetal venous return
Early Decelerations Cause
Head Compression -> reflex vagal response c resultant slowing of FHR during the UC.
What does Early Decelerations look like
A mirror reflection of the cxt
What does Variable Deceleration look like
V or W
Variable Deceleration causes
Cord Compression
Can be periodic or Non-periodic (Episodic)
Short cord
Knot in cord
Prolapsed cord = emergency situation
Late Deceleration causes
Uteroplacental insufficiency
Maternal Hypotension/hypertension
Diabetes
Decrease in fetal oxygen reserves
Cause by impairment in oxygen exchange
What is the BIG 5 Interventions
Stop the Oxytocin/Pitocin
Turn the patient or reposition the patient
02 per facemask – 8 to 10 L/min
IV fluids or Fluid bolus
Call Health Care Provider
VEAL
Variable Deceleration
Early Deceleration
Acceleration
Late Deceleration
CHOP
Cord Compression
Head Compression
Oxygen/Movement
Placental/Uterine insufficiency
MINE
Move the patient
Investigate if delivery is coming
Nothing – this is a good sign
Everything/Know the Big 5
Category 1
Baseline: 110-160 bpm
Moderate variability
No Late or Variable decels,
+/- Early decels,
+/- Accels
Category II
Everything not categorized as Category I or III
Examples :
Tachy, Brady with normal variability
Absent, minimal, or marked variability
Lates + mod variability, unusual variables
Category III What is it
Absent variability, plus either…..
Recurrent late/variable decels, Bradycardia
Sinusoidal pattern
Category III
Abnormal Fetal Acid and base status
Aminofusion
Infusion of room-temperature isotonic (normal saline, lactated Ringer’s solution) fluid into the uterine cavity to relieve intermittent umbilical cord compression resulting in in variable decelerations and transient fetal hypoxemia.
Purposes of Aminofusion
Treatment of Variable Decels
Low amniotic fluid
