FHR

Question 1

When is baseline FHR measured

Answer 1

When woman has no contractions and fetus is not expierencing episodic FHR changes

Question 2

How can a normal baseline FHR be obtained

Answer 2

auscultation, ultrasound, doppler or by continuous internal direct fetal electrode

Question 3

What are the causes of fetal bradycardia

Answer 3

hypoxia
prolonged maternal hypoglycemia
fetal acidosis
admin of analgesic drugs to mom
hypothermia
epidural
maternal or fetal hypotension
Prolonged umbilical cord compression
fetal congenital heart block

Question 4

When is bradycardia a ominous sign?

Answer 4

When accompanied with decrease in baseline variability and late decelerations

Question 5

What could be causes of fetal tachycardia

Answer 5

Early compensatory response to asphyxia
Fetal hypoxia
Maternal fever
Maternal dehydration, amnionitis, drugs
Maternal hyperthyroidism, anxiety
Fetal anemia
Prematurity
Fetal infection
Chronic hypoxemia
Congenital amonalies
Fetal heart failure
Fetal arrhythmias

Question 6

When is fetal tachycardia considered an omnious sign?

Answer 6

accompanied by decrease in variablility and late decels

Question 7

What is absent or minimal variability

Answer 7

caused by fetal acidemia secondary to uteroplacental insufficiency, cord compression, a preterm fetus, maternal hypotension, uterine hyperstimulation, abruptio placenta or fetal dysrhythmia

Question 8

What are the interventions to uteroplacental blood flow and perfusion through umbilical cord?

Answer 8

Lateral positioning of mother
Increase IV fluid rate to improve maternal circulation
admin O2 8-10L by mask
Internal fetal monitoring
document and report

Question 9

What does moderate viablility indicate

Answer 9

autonomic and CNS of fetus are well developed and oxygenated well

Question 10

When does Marked variability occurs?

Answer 10

greater than 25 bpms of flucuation in baseline

Cord prolapes or compression, maternal hypotension, uterine hyperstimulation, abruptio placenta

Question 11

What are the interventions for marked variability

Answer 11

determining cause, if possible
Lateral positioning
increasing IV rate
admin 02 8-10L by mask
discontinue oxytocin infusion
observe for changes in tracing
Internal fetal monitoring

Question 12

FHR variability is an important clinical indicator that is predictive of ?

Answer 12

Fetal acid base balance and cerebral tissue perfusion

Question 13

How many BPM is absent variablility

Answer 13

range undectable

Question 14

How many BPM is minimal variablility

Answer 14

fever than 5 bpm

Question 15

How many BPM is moderate variablility

Answer 15

6-25bpm

Question 16

How many BPM is marked variablility

Answer 16

more than 25bpm

Question 17

When are early decels usually seen and are thought to be the result of?

Answer 17

-active stage of any normal labor, during pushing, crowning or vaccum extraction

-fetal head compression that results in reflex vagal response

Question 18

Late decels are associated with

Answer 18

uteroplacental insufficiency - blood flow is decreased that fetal hypoixa or myocardial depression exists

Question 19

What are conditions that decrease uteroplacental perfusion with resultant decels?

Answer 19

maternal hypotension
gestational HTN
placental agin secondary to diabetes and postmaturity
hyperstimulation via oxytocin
maternal smoking
anemia and cardiac disease

*imply some degree of fetal hypoxia

Question 20

Variable decels are assoc with

Answer 20

Cord compression
Classified either 2 or 3 depending on change in baseline variability

Question 21

What are some factors assoc with prolonged decels?

Answer 21

prolonged cord compression, abruptio placenta,cord prolapse, supine maternal position, vaginal exam, fetal blood sampling, maternal seizures, regional anesthesia, uterine rupture

Question 22

Sinusoidal pattern

Answer 22

visually apparent smooth sinewave like undulating pattern in FHR with a cycle freq of 3-5bpm that persists for more than 20 min

Question 23

What could cause sinusoidal pattern

Answer 23

derangement of CNS control of FHR and occurs when a severe degree of hypoxia seconday to fetal anemia and hypovolemia is present.
*always category 3
** to correct a fetal intrauterina transfusion would be needed.