Fetal Monitoring in Labour Flashcards
What is done for most low-risk pregnancies?
What is used to monitor the baby in more high-risk pregnancies?
Intermittent auscultation
CTG - Cardiotocography - electronic fetal heart monitoring
Signs of distress:
- What will happen to auscultation?
- What could be in the liquor which could lead to neonatal pneumonitis?
- Significant moulding - what is it? what does it suggest?
- What can be done once fetal distress is identified to identify hypoxia?
Could be abnormal
Meconium in liquor
Overlapping of skill bones - a sign of obstructed labour
Fetal scalp blood to detect acidosis which is a sign of hypoxia
Cardiotocography (CTG):
What does it monitor? - 2
What do regular contractions suggest if the mother is newly presenting?
What is the baseline rate? What is the normal range?
What are accelerations?
Fetal HR and uterine contractions
Labour
A visualised average line running through the fetal HR
Normal is 110-160 - above or below this is abnormal
Occasional jumps in fetal HR in response to its environment
Cardiotocography (CTG):
What is variability? What is abnormal?
What are decelerations?
What is normal?
What do late decelerations suggest?
What do variable decelerations suggest?
Reflecting a responsive fetus (>5 is normal)
(<5 in 40 minutes = non-reassuring)
(<5 in 90 minutes = abnormal)
Early decelerations, in time with contractions
Late - 20-30 second after contraction = hypoxia
Variable - cord compression
Fetal blood scalp:
7.3-7.4 is normal.
What should be done if the pH is:
- < 7.3
- <7.25
- <7.2
Repeat in 30 mins if CTG still abnormal
Repeat in 30 mins and consider c-section
Urgent CS
