Fetal Bradycardia

Question 1

how is fetal bradycardia defined?

Answer 1

baseline HR less than 110 for greater than 10 minutes

*10 minutes indicates a new baseline

Question 2

First steps in appearance of fetal bradycardia?

Answer 2

1. vaginal exam to assess for cord prolapse
2. Put mother on side (relieved pressure on great vessels
3. IV fluid bolus if pt might be hypovolemic (ephedrine as vasopressor if needed in face of hypotension)
4. Administration of 100% O2 by facemask
5. Stopping oxytocin if being given, sometimes IV terbutaline to stop uterine pressure on baby
   * also must differentiate fetal pulse form maternal with fetal scalp electrode

Question 3

what FHR findings indicate adequate oxygenation

Answer 3

Variable accelerations (over 15 from baseline for 15 seconds)

Question 4

why might a woman in labor develop new hypotension?

Answer 4

epidural agents cause vasodilation, can drop B and hypo perfuse fetus—> can cause late decelerations

Question 5

what can meperidine cause in FHR tracings?

Answer 5

decreased variability–> is a sedative

Question 6

What is a risk of misoprostol use?

Answer 6

Causes tachysystole (0ver 5 contractions in 10 minutes), which can lead to prolonged fetal decels or fetal bradycardia

Question 7

what are three early findings in uterine rupture?

Answer 7

fetal brady
deep variable decelerations
late decelerations

Question 8

what two fetal presentations are associated with a higher risk of cord prolapse

Answer 8

1. footling breech

2. transverse lie