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ENRP > Fetal Surveillance During Labor > Flashcards

Fetal Surveillance During Labor Flashcards

1
Q

How does FHR monitoring effect fetal neurologic damage/death?

A

It does NOT decrease it!

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2
Q

Even though FHR monitoring does not decrease fetal neurologic damage or death, what is good about it?

A

Good outcomes are associated with normal FHR data and it can provide a warning of potential problems

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3
Q

What does a Doppler US Transducer measure?

A

External on abdomen

= Records sound waves from the fetal heart

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4
Q

What does a Tocodynamometer measure?

A

External

= Detects and records contraction frequency only

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5
Q

Internal Fetal Monitoring is the most accurate. What are 2 options and which can measure the intensity of contractions?

A
  1. Fetal Scalp Electrode

2. Intrauterine Pressure Catheter - measures intensity

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6
Q

Blood flow from maternal circulation crosses the placenta and supplies the fetus with oxygen. During a contraction, what occurs?

A

Blood flow is temporarily stopped

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7
Q

A fetus who cannot tolerate the stress of contractions may become ___ and show ____ changes

A

Hypoxic with FHR changes

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8
Q

What does the upper tracing show?

A

FHR (Fetal Heart Rate)

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9
Q

What does the lower tracing show?

A

Uterine Contractions

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10
Q

For the FHR tracing, what do the horizontal lines measure?

A

FHR in bpm

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11
Q

For the Uterine Contractions, what does the horizontal lines measure?

A

Pressure of contractions

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12
Q

For the upper and lower tracings, describe the vertical lines

A

Each small box = 10 seconds

Each think line = 1 minute

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13
Q

What is a normal value for Uterine Contractions?

A

Less than 5 contractions in a 10 minute period

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14
Q

What defines Uterine Tachysystole?

A

> 5 contractions in a 10 minute period

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15
Q

More than 5 uterine contractions in a 10 minute period

A

Uterine Tachysystole

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16
Q

What are Montevideo Units (MVU)?

A

The sum of the pressures with each peak contraction in a 10 minute period for 2+ hours

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17
Q

What is normal value for MVU?

A

> 200

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18
Q

When do you assess Baseline FHR?

A

Between contractions

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19
Q

Normal Baseline

A

110 - 160 bpm

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20
Q

Tachycardia Baseline

A

> 160 bpm

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21
Q

What can cause Tachycardia Baseline?

A

Early fetal hypoxia

*fetal infection (chorioamnionitis)

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22
Q

Bradycardia Baseline

A

< 110 bpm

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23
Q

What can cause Bradycardia Baseline?

A

Late fetal hypoxia

Meds

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24
Q

Baseline Variability is fluctuations in the baseline FHR. How is it measured?

A

Amplitude of peak to trough in bpm

25
Amplitude of peak to trough in bpm of change in baseline rate
Baseline variability
26
Absent Baseline Variability
Amplitude range is undetected
27
Minimal Baseline Variability
Amplitude range is < 5 bpm
28
Moderate Baseline Variability
Amplitude range is between 6 - 25 bpm
29
Marked Baseline Variability
Amplitude range > 25 bpm
30
What type of Baseline Variability is normal?
Moderate -- range between 6 - 25 bpm
31
What type of Baseline Variability is associated with possible fetal stress?
Decreased Variability
32
Decreased Baseline Variability is associated with what 2 things?
``` Hypoxia Acidosis (pH < 7.2) ```
33
What should you do if you see Decreased Variability to differentiate fetal sleep from acidosis? What should you see?
Fetal Scalp Stimulation | -- should see an associated Acceleration
34
What are 2 categories of Periodic FHR changes and when are they seen?
Accelerations Decelerations -- seen with uterine contractions
35
If the FHR during a uterine contraction is the same as the preceding baseline FHR, what is that called?
No change
36
If the baby is > 32 weeks, what is a normal Acceleration?
FHR > 15 bpm above baseline for > 15 seconds but not more than 2 minutes
37
If the baby is < 32 weeks, what is a normal Acceleration?
FHR > 10 bpm above baseline for > 10 seconds but not more than 2 mins
38
What defines a Prolonged Acceleration?
If the Acceleration lasts more than 2 minutes
39
When is a Change in Baseline noted?
If the Acceleration or Deceleration lasts more than 10 minutes
40
Are Accelerations normal?
YES - reassuring response
41
What are 3 causes of Accelerations?
Fetal movement Fetal Scalp Stimulation Vaginal Exam
42
What is a Deceleration?
FHR decreases with a uterine contraction
43
What are 3 types of Decelerations?
Early Variable Late
44
What causes Early Decelerations?
Head Compression
45
With fetal head compression, what change in FHR should you see?
Early Deceleration
46
What do Early Decelerations look like?
Mirror image | = Occur at the same time as the uterine contraction peak
47
What causes Variable Decelerations?
Umbilical Cord Compression
48
With umbilical cord compression, what FHR change should you see?
Variable Deceleration
49
When do Variable Decelerations occur on the FHR strip?
Can occur before, during or after the beginning of a uterine contraction
50
What causes Late Decelerations?
Uterine placental insufficiency | -- excess uterine activity or maternal supine hypotension
51
With excessive uterine activity or maternal supine hypotension (uterine placental insufficiency), what FHR change will be seen?
Late Deceleration
52
How do Late Decelerations look?
Occur AFTER peak of contraction
53
What is the most ominous Deceleration type and why?
Late Decelerations | -- may indicate fetal acidosis
54
What defines a Prolonged Deceleration?
Decreased FHR > 15 bpm below baseline lasting more than 2 minutes
55
When are Prolonged Decelerations commonly seen?
Maternal pushing
56
If you see a sinusoidal pattern of FHR, what does that mean?
Fetal anemia
57
What pattern of FHR will be seen with fetal anemia?
Sinusoidal pattern
58
If there is umbilical cord compression, what is a possible treatment?
Amnioinfusion | - saline though the IUPC
59
With Variable Decelerations, what is a possible treatment?
Amnioinfusion | - saline through the IUPC

ENRP (45 decks)

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