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ENRP Exam 1 > Fetal Heart Monitoring Dr. Moulton > Flashcards

Fetal Heart Monitoring Dr. Moulton Flashcards

1
Q

External Electronic Fetal Heart Monitoring 2 devices

A
  1. Doppler US transducer = records sound waves from fetal heart
  2. Pressure Sensitive Tocodynanmometer transducer = defects contractions (f of contractions) , + fetal response to it (can be off if mother is obese)
    = does NOT reduce cerebral palsy cases
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2
Q

Internal Electronic Fetal Heart Monitoring 2 devices

A
  1. Fetal Scalp Electrode (FSE) =rupture through sac and screw on to baby’s head, accurate Heart monitoring
  2. Intrauterine Pressure Catheter (IUPC : catheter placed giving STRENGTH of contractions

= membrane is ruptured in both, more accurate

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3
Q

O2 to baby during contractions

  1. What determines fetal HR
  2. PH in hypoxia
A

Is interrupted, so if there is good oxygenation between contractions then baby wound have hypoxia = hypoxia in fetus will build up lactic acid and get acidosis (contractions effect fetal HR)

  1. Atrial pacemaker
  2. PH = 7.25-7.30 normal, pH = under 7.20 is hypoxia
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4
Q

Fetal Monitoring Strip is set up how

A
  1. Top line is fetal HR
  2. Bottom line is Contractions in uterus

= 1 small box is 10sec across and 10beats up, 1 big box is 1min

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5
Q

Normal uterine contractions

Tachysystole uterine contractions

A
  1. Normal = 5 Contractions or less in 10min (average in 30min)
  2. Tachysystole = more then 5 contractions in 1min (average in 30min) (check for decelerations )
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6
Q

Montevideo Units (MVUs)

  1. What is this
  2. How can you get this
A
  1. Sum of all contraction strengths in 10min for at least 2hrs
  2. IUPC
  3. Over 200, then dont continues giving pitocin (if still not ready to deliver then another of the 3Ps is the problem)
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7
Q

Fetal HR is normal, tachy, and Brady

A
  1. Normal = 110-160
  2. Tachycardia = over 160
  3. Bradycardia = under 110
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8
Q

Things that can cause fetal Bradycardia

A
  1. Fetal Hypoxia - late sign
  2. Anesthesia or Pitocin
  3. Maternal Typotension
  4. Compressed umbilical cord
  5. Heart block
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9
Q

Reasons for fetal tachycardia

A
  1. Fetal hypoxia (early sign)
  2. Oxytocin (excessive)
  3. Arrhythmia
  4. Prematurity
  5. Maternal Fever
  6. Fetal Infection**
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10
Q

Variability in Fetal HR

A

Peak to most bottom on the fetal strip

  1. Absent = no range
  2. Minimal = less then 5bpm
  3. Moderate = NORMAL from 6bpm-25bpm**
  4. Marked = over 25bpm
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11
Q

cause of low HR variability of fetus

A

Usually from hypoxia leading to acid environments

  1. Prematurity
  2. Sleep
  3. Maternal Fever
  4. Fetal Tachycardia
  5. Hyperthyroidism mother
  6. Mother illicit drugs, fetal congenital anomalies
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12
Q

Acceleration in fetal HR means what

A

Abrupt increase in HR (normal)

  1. If over 32 weeks = 15bpm over baseline for 15sec -2min
  2. Less then 32 weeks = 10bpm over baseline for 10sec-2min
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13
Q

Prolonged acceleration vs change in baseline

A
  1. Prolonged = over 2min

2. Change in baseline = over 10min

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14
Q

Causes of accelerations

A
  1. Fetal movement
  2. Scalp stimulaiton or vibroacustic stimulation
  3. Vaginal examination
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15
Q

Decelerations are what

A

Decrease in Fetal HR after a contraction

= early, variable, late

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16
Q

Early Decelerations

A

GOOD
= secondary to head compression (increased intracranial P —> lower BF—> activated central vagus N —> lower HR)
= happens at the same time as contraction

17
Q

Variables Decelerations happen how and means

A

Can be good or bad

  1. Secondary to Umbilical cord compression (especially after rupture)
  2. Can happen before during or after contraction (sharp peaks usually more then 15bpm down)
18
Q

Late decelerations means what and happens when

A
  1. bad
  2. Uterine placental insufficiency (UPI)
    = fetal acidosis, low arterial pH
    = after the contractions
19
Q

Prolonged Decelerations are what and means

A
  1. HR decrease more the 15bpm for over 2min -10min

2. O2 disruption to fetus (usually during maternal pushing)

20
Q

Sinusoidal Pattern of fetal HR means what and happens when

A
  1. not good
  2. Fetal anemia need EM c-section useless giving birth
    = curve goes up and down like a sine curve
21
Q

Category 1 pregnancy means

A

Baby will do good

  1. HR 110-160
  2. Moderate variability
  3. Early decelerations + accelerations can be present
22
Q

Category 2 pregnancy means

A

Baby can do fine

  1. Variable decelerations (less the 50% of them) = baby is fine
  2. Variable decelerations (more then 50%) = umbilical cord compression , acidemia —-> modify how mom sits, aminoinfusion, stop pushing for a bit
  3. No variability = improve oxygenation , position mom to left recumbent
23
Q

Amnioinfusion is what

A

Normal Saline through IUPC to prevent cord compression

24
Q

Category 3 what to do

A

bad things you see, fetus can not do that fine
1. Recurrent late decelerations
2. Bradycardia
3. Sinusoidal pattern
4. Recurrent variable decelerations (over 50%)
= prepare for delivery, O2, IV saline, scalp stimulation, reposition mother

25
Q

EM C-section how many minutes do you have to get baby out

A

30min

26
Q

Spontaneous rupture happens and baby has no variability and 50HR what do you do

A

When where cord is, reposition mom, ask if pitocin has been started , if nothing helps = EM c- section

27
Q

Reactive Stress Test what (GOOD STRESS TEST)

A

15bpm above base line lasting 15sec , 2 times within 20min

28
Q

Fetal HR for compression umbilical cord

A

Variable decelerations
Prolonged deselection
Fetal Bradycardia

ENRP Exam 1 (13 decks)

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