Fetal Heart (Moulton)

Question 1

Benefit of Fetal Rate Heart (FHR) Monitoring

Answer 1

reassurance that >98% that good fetal/neonatal outcome is associated with normal continuous FHR data

Question 2

Which fetal monitoring provides the most accurate tracing?

Answer 2

internal monitoring; Fetal scalp electrode - avoid in HIV pts and Intrauterine pressure catheter (IUPC)

Question 3

Pressure sensitive tocodynanmometer transducer

Answer 3

external fetal monitoring; detects and records contractions; DOES NOT provide strength of the contraction

Question 4

Fetal oxygen reserve

Answer 4

only enough to meet metabolic demands for approx. 1-2 mins

Question 5

How is the fetal heart rate determined?

Answer 5

by atrial pacemakker

Question 6

Normal pH of fetal scalp blood

Answer 6

pH 7.25-7.30
**acidosis pH <7.20

Question 7

Fetal scalp pH of what is considered abnormal/acidotic?

Answer 7

pH <7.20; normal range pH 7.25-7.30

Question 8

Normal uterine contractions

Answer 8

5 contractions or less in 10 mins or 3 contractions in 8 mins (once every 2-3 mins)
Tachysystole >5 contractions in 10 mins

Question 9

When are uterine contractions considered tachysystole?

Answer 9

> 5 contractions in 10 mins

Question 10

Normal fetal heart rate

Answer 10

normal 110 - 160 bpm
tachycardia >160 bpm
bradycardia <110 bpm

Question 11

What is the most common cause of fetal tachycardia?

Answer 11

Fetal infection - chorioamnionitis

Question 12

What is the normal fetal heart rate variability?

Answer 12

amplitude range 6-25 bpm
minimal <5 bpm
marked >25 bpm
absent = undetectable

Question 13

Decreased fetal heart rate variability

Answer 13

indicator for fetal stress; associated with hypoxia and acidemia; can be caused by: maternal drugs/substance abuse, maternal hyperthyroidism, prematurity

Question 14

Accelerations

Answer 14

fetal heart rate changes with uterine contractions; an increase in FHR is a normal reassuring response >32 weeks; FHR above 15 bpm for about 2 mins

Question 15

Prolonged accelerations

Answer 15

FHR above 15 bpm for more than 2 mins; not too concerning

Question 16

Decelerations

Answer 16

FHR decreases in response to uterine contractions; classified as early, variable and late

Question 17

Early decelerations

Answer 17

deceleration occurs at the same time as the peak of the contraction and thus “mirror image”; not associated with fetal distress

Question 18

Variable decelerations

Answer 18

secondary to umbilical cord compression; big “V” for variable; can occur before, during, or after contractions start

Question 19

Late decelerations

Answer 19

deceleration occurs after peak of contraction; caused by uterine placental insufficiency (UPI); most ominous deceleration (very concerning); usually indicated fetal metabolic acidosis or low arterial pH

Question 20

What is the most ominous deceleration?

Answer 20

a late deceleration; usually indicated by fetal metabolic acidosis or low arterial pH

Question 21

Potential causes of late decelerations

Answer 21

Excessive uterine activity
Maternal supine hypotension

Question 22

The pattern on Fetal Heart Monitoring indicating fetal anemia

Answer 22

Sinusoidal pattern; smooth wave-like undulating pattern

Question 23

What is the best fetal heart category to be in?

Answer 23

category I - normal

Question 24

Which fetal heart category do you start getting nervous about?

Answer 24

category III - abnormal; sinusoidal pattern; absent baseline variability

Question 25

When the fetal scalp is stimulated, fetal pH should almost always be greater than what?

Answer 25

pH 7.22 or greater

Question 26

Electronic Fetal monitoring has a >99% false positive rate for detecting what?

Answer 26

cerebral palsy