Fetal HRM - Moulton Flashcards
What can cause fetal bradycardia?
Fetal hypoxia Anesthesia Pitocin Maternal hypotension Heart block Compressed umbilical cord
What is the cause of variable decelerations?
What is seen on the tracing?
Umbilical cord compression
Shoulder sign
What is the most common cause of tachycardia in fetus?
What else?
Chorioamnionitis
Fetal hypoxia, excessive oxytocin, arrhythmia
What is the cause of late decelerations?
Uterine placental insufficiency (UPI)
What constitutes a category 2 strip?
Baseline of 110-160 w/variable decels noted
What indicates a fetal pH > 7.22 in scalp stim test?
Acceleration of 15 bpm lasting 15 seconds
What is normal pH of fetal scalp blood?
What is fetal acidosis?
7.25 - 7.30
PH < 7.20
What is the goal in category II FHR level?
Cause?
Promote fetal oxygenation
Meds
Fetal sleep
Acidemia
Etc
Sinusoidal pattern means what?
Fetal anemia
What constitutes a category 3 strip?
Recurrent late decelerations
Absent variability
Normal FHR?
110-160
Tachycardia above 160
Bradycardia below 110
What can you do if recurrent variables are noted on the fetal strip?
How?
Amnioinfusion
Start w/250-1000 cc infused at rate of 15 cc/min
Then continuous infusion of 100-200 cc/hr
DEC variability is an indicator of what?
Associated with what?
Fetal stress
Hypoxia and acidemia
What is the fetal scalp stim test especially useful for?
Differentiate fetal sleep from acidosis
What is the management in category II FHR pattern?
Usually due to what?
Amnioinfusion
Umbilical cord compression
What are potential causes of late decelerations?
Excessive uterine activity
Maternal supine hypotension
What does the FHR tracing look like in category III?
Goals/management?
Absent baseline variability, sinusoidal
Prepare for delivery, scalp stim test
When is prolonged deceleration commonly seen?
Maternal pushing
What is a normal Montevideo unit total?
> 200 unit in a 10 minute period for at least 2 hours
What is the cause of early decelerations?
Head compression (Inc ICP)
Not assoc w/fetal distress
Prolonged acceleration defined how?
Change in baseline?
> 2 minutes
Acceleration lasts > 10 min
What do repetitive late decelerations indicated?
Fetal metabolic acidosis and low arterial pH
What are the causes of acceleration?
Spontaneous fetal movement
Scalp stim
Vaginal exam
Normal uterine activity defined how?
Tachysystole?
5 contractions or less in 10 min
> 5 contractions in 10 minutes
An abrupt increase in FHR is a normal reassuring response and at > 32 weeks what is the HR inc?
< 32 weeks?
15 bpm above baseline for 15sec to 2 min
10 bpm above baseline for 10sec to 2 min
IUPC requires what?
Provides what?
Membranes to be ruptured
Most accurate information
What is normal baseline variability?
Minimal?
Marked?
6-25 bpm
< 6
> 25
FHR monitoring has not benefit in decreasing what?
But can increase what?
Cerebral palsy
Operative vaginal deliveries and c-sections
