Fetal Bradycardia

Question 1

First step in the evaluation of fetal bradycardia

Answer 1

In the face of ROM, you should rule out umbilical cord prolapse

Question 2

Treatment for cord prolapse

Answer 2

Cesarean delivery

Question 3

Predispositions to cord prolapse

Answer 3

Unengaging presenting part

Transverse lie with ROM

Question 4

Engagement

Answer 4

Largest transverse (biparietal) diameter of the fetal head has negotiated the bony pelvic inlet

Question 5

Clinical approach to fetal bradycardia

Answer 5

Confirm fetal HR (vs maternal)
Vaginal exam to assess for cord prolapse
Place patient on left side in order to move the uterus from the great vessels –> improves blood return to the heart
IV fluid bolus
Administer 100% oxygen by face mask
Stop oxytocin (if it is being given), and start beta-agonist of tachysystole

Question 6

Given to relax the uterine musculature

Answer 6

Terbutaline (beta agonist)

Question 7

Tachysystole

Answer 7

6 or more contractions in a 10 minute period