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Obstetrics > Fetal Monitoring & Assessment > Flashcards

Fetal Monitoring & Assessment Flashcards

1
Q

Normal HR variability in the fetus is a reflection of what?

A

intact neurological modulation

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2
Q

The loss of HR variability in the fetus is the single most reliable sign of what?

A

fetal compromise

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3
Q

What medication is most associated with a decrease in fetal HR variability?

A

narcotics

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4
Q

What is normal fetal HR acceleration at 32 weeks or more?

A

15 beats for 15 seconds

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5
Q

How is fetal bradycardia defined?

A

fetal HR < 110 bpm for a 10 minute period

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6
Q

fetal bradycardia is associated with mother’s who have this systemic disease.

A

Lupus

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7
Q

How is fetal tachycardia defined?

A
  • mild = 161-180

- severe = >180

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8
Q

When does an early deceleration begin and end?

A

begins with the onset of contraction and ends with its completion

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9
Q

What is the cause of variable decelerations?

A

cord compression

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10
Q

What is the most common periodic change in the fetal HR in labor?

A

variable deceleration

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11
Q

When does a late deceleration begin?

A

begins 20-30 seconds after the contraction

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12
Q

What is the cause of late deceleration?

A

uterine-placental insufficiency

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13
Q

What is the cause of early deceleration?

A

head compression causes a vagal stimulation

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14
Q

These 2 criteria must be met for internal fetal HR monitoring to be done.

A
  • fetal membranes must be ruptured

- cervix must be partially dilated

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15
Q

A patient is doing well and has no significant findings. She can proceed with labor as tolerated. What category is she under for classifications of fetal tracings?

A

Category 1

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16
Q

This category is associated with abnormal tracings and abnormal fetal acid-base.

A

Category 3

17
Q

This category is indeterminate. It requires further evaluation and continued surveillance.

A

Category 2

18
Q

What is a normal finding on a scalp stimulation test?

A
  • stimulation of the fetal scalp with constant pressure results in an increase in FHR by 10 bpm
19
Q

What is the goal of antepartum fetal surveillance?

A

identification of suspected fetal compromise before progressive metabolic acidosis leads to fetal death

20
Q

What is a normal finding on a non stress test?

A

2 accelerations of the FHR > 15 bpm above the baseline lasting at least 15 seconds within 20 minutes

21
Q

What is a positive test on a contraction stress test?

A
  • repetitive late decelerations following 50% or more of the contractions
22
Q

What is a contraction stress test done for?

A

assess if a vaginal delivery attempt can be undertaken

23
Q

A biophysical profile looks at these 4 factors.

A
  • fetal breathing
  • fetal movement
  • fetal tone
  • amniotic fluid volume
24
Q

What is a biophysical profile?

A
  • ultrasound evaluation for fetal well being
25
Q

What biophysical profile score is considered normal?

What biophysical profile score is considered abnormal?

A
  • normal = 8/8

- abnormal = 4/8

26
Q

Potter’s syndrome aka renal agenesis is associated with what amniotic fluid abnormality?

A
  • oligohydramnios
27
Q

How is oligohydramnios defined?

A

an amniotic fluid index <5 cm or a max vertical pocket <2 cm

28
Q

How is polyhydramnios defined?

A
  • amniotic fluid index >24cm

- max vertical pocket >8cm

29
Q

What is the most common cause of MILD polyhydramnios?

A

idiopathic

30
Q

What are the 5 causes of polydramnios?

A
  • fetal malformation (most GI)
  • twin-twin transfusion
  • hydrops fetalis
  • DM
  • idiopathic
31
Q

A normal umbilical cord consists of how many arteries and veins?

A

2 arteries and 1 vein

32
Q

When is a single umbilical artery diagnosed?

A

at the time of second trimester ultrasound

33
Q

Doppler studies are used to assess what?

A

placental function

34
Q

What should you do if the fetal tracings are a category III?

A

prompt delivery!

35
Q

What should you do if the fetal tracings are a category II and the fetus responds to scalp stimulation?

A

continue surveillance

36
Q

What should you do if the fetal tracings are a category II and the fetus does not respond to scalp stimulation?

A

consider delivery

Obstetrics (12 decks)

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