Fetal Bradycardia

Question 0

-3 station suggests?

Answer 0

Fetal head unengaged

Question 1

Patient with persistent fetal bradycardia after artificial rupture of membranes – next step?

Answer 1

Vaginal examination to assess for umbilical cord prolapse

Question 2

Definition of fetal bradycardia?

Answer 2

Fetal heart rate <110 for greater than 10 minutes

Question 3

Definition of umbilical cord prolapse?

Answer 3

Umbilical cord enters through the cervical os, in front of the presenting part

Question 4

Ways to confirm fetal bradycardia?

Answer 4

Scalp electrode or ultrasound

Question 5

Maneuvers to improve maternal oxygenation and delivery of cardiac output to the uterus?

Answer 5

1. Placement of the pt on her side (moves the uterus from the great vessels, improving blood return to the heart)
2. IV fluid bolus if Volume depleted
3. Oxygen by facemask
4. Stopping oxytocin

Question 6

Signs of hyperstimulation with oxytocin? Management?

Answer 6

Uterus will be tetanic or uterine contractions will be frequent (every minute)

Beta agonist will relax musculature

Question 7

If confirmed umbilical prolapse – management?

Answer 7

Elevation of the presenting part digitally and emergency section

Question 8

Signs of uterine rupture in woman with prior C-section? Treatment? Use of intrauterine pressure catheters?

Answer 8

1. Fetal bradycardia
2. Deep variable decelerations or late decelerations

C-section

Not helpful in diagnosis of uterine rupture

Question 9

Definition of uterine hyperstimulation? Cause?

Answer 9

More than five uterine contractions and a 10 minute.

Prostaglandin cervical ripening agents, especially misoprostol