Intrapartum

Question 0

The fetal heart rate is detected through the maternal abdominal wall using the ultrasound Doppler principle

Answer 0

EXTERNAL (Indirect) electronic fetal heart rate monitoring

Question 1

The fetal heart rate may be measured by attaching a bipolar spiral electrode directly to the fetus

Answer 1

INTERNAL (Direct) electronic fetal heart rate monitoring

Question 2

The necessity for membrane rupture and uterine invasion may be avoided by use of external detectors to monitor fetal heart action and uterine activity

Answer 2

EXTERNAL (Indirect) electronic fetal heart rate monitoring

Question 3

The ultrasonic waves in the external fetal heart rate monitoring undergo shifts in frequency as they reflected from:

Answer 3

Moving fetal heart valves

Pulsatile blood ejected during systole

Question 4

The mean FHR rounded to increments of __ bpm during a __ minutes segmen

Answer 4

5 bpm

10 minutes

Question 5

The normal baseline FHR:

Answer 5

110-160 bpm

Question 6

What is the FHR in bradycardia?

Answer 6

<110 bpm

Question 7

What is the FHR in Tachycardia?

Answer 7

> 160bpm

Question 8

This can cause fetal bradycardia:

Answer 8

H - hypoxia
A - arrythmias
B - beta blockers
C - congenital heart blocks
M - maternal hypotension

Question 9

Causes of fetal tachycardia:

Answer 9

M - maternal fever
F - fetal infection
H - hypoxia
B - beta mimetics
H - hyperthyroidism
A - arrhtyhmia

Question 10

Baseline FHR Variability:

Amplitude range is undetectable

Answer 10

Absent

Question 11

Baseline FHR Variability:

Amplitude range is 5 bpm or fewer

Answer 11

Minimal

Question 12

Baseline FHR Variability:

Amplitude range of 6-25 bpm

Answer 12

Moderate

Question 13

Baseline FHR Variability:

Amplitude range >25bpm

Answer 13

Marked

Question 14

Significance of a normal FHR variability

Answer 14

Excellent indicator of good fetal well being

Question 15

Causes of decreased or absent variability:

Answer 15

AA - asphyxia / fetal acidemia
S - fetal sleep
P - prematurity
D - magnesium sulfate, diazepam, meperidine
A - atropine
D - defective conduction system

Question 16

It is generally believed that ________ is the single most reliable sign of fetal compromise

Answer 16

Reduced baseline heart rate variability

Question 17

A specific fetal heart rate pattern defined as having a visually apparent, smooth, sine-wave undulating pattern in FHR baseline with a cycle frequency of ____ minute that persist for ____ minutes

Answer 17

Sinusoidal fetal heart rate pattern

2-5/minutes persist for >=20 minutes

Question 18

Fluctuations in the FHR of 2 cycles per minute or greater

Answer 18

Baseline variability

Question 19

A visually apparent increase (onset to peak in less than 30 seconds) in the FHR from the most recently calculated baseline

Answer 19

Acceleration

Question 20

Accelerations are always reassuring and always confirming that the fetus is not ___ at that time

Answer 20

Acidemic

Question 21

In association with a uterine contraction a visually apparent gradual (onset to nadir of __ seconds) decrease in FHR with return to baseline, nadir of the deceleration occurs at the same time as the peak of the contraction

Answer 21

> = 30 seconds

Early deceleration

Question 22

What is the pathophysiology of early deceleration:

Answer 22

Head compression > Vaal stimulation > affects the FHR

Question 23

In association with a uterine contraction a visually apparent gradual (onset to nadir of __ seconds) decrease in FHR with return to baseline, onset, nadir and recovery of the deceleration occurs at the beginning, peak, and end of the contraction respectively

Answer 23

Late deceleration

Question 24

Causes of late decelerations:

Answer 24

U - utero-placental insufficiency M - maternal hypotension U - uterine hyperactivity

Question 25

An abrupt (onset of nadir of < 30 seconds), visually apparent decrease in the FHR below the baseline

Answer 25

Variable deceleration

Question 26

The decrease in FHR is 15 bpm or more, with a duration of >= 15 seconds but less than 2 minutes

Answer 26

Variable deceleration

Question 27

The most common deceleration pattern encountered during labor

Answer 27

Variable deceleration

Question 28

Cause of variable deceleration

Answer 28

Umbilical cord compression

Question 29

What are the markers of a prolonged deceleration:

Answer 29

Decrease in FHR | >= 15 bpm from baseline, >= 2 minutes but < 10 minutes in duration from onset to return to baseline

Question 30

Common cause of prolonged deceleration:

Answer 30

C - cervical examination U - uterine hyperactivity C - cord entanglement M - maternal supine hypotension

Question 31

Other causes of prolonged deceleration:

Answer 31

``` C - conduction analgesia M - maternal hypothermia A - abruption U - umbilical cord prolapse M - maternal seizure V - Valhalla maneuver ```

Question 32

This measurement of the pH in ____ may help identify the fetus in serious distress

Answer 32

Fetal scalp blood sampling

Question 33

If the pH is greater than 7.25 what will you do?

Answer 33

Labor is observed

Question 34

If the pH is between 7.20 - 7.25 what will you do?

Answer 34

Measurement is repeated within 30 minutes

Question 35

If the pH is less than 7.20 what will you do?

Answer 35

Get another scalp blood sample, mother is taken to the OR

Question 36

If the repeat is pH < 7.20 what will you do?

Answer 36

Deliver

Question 37

This failure to provoke acceleration was not uniformly predictive of fetal acidemia

Answer 37

Scalp stimulation

Question 38

If in the scalp stimulation there is a positive fetal heart rate acceleration, this indicates?

Answer 38

Normal pH

Question 39

The technique that involves the usage of an electronic artificial larynx which is placed directly unto the maternal abdomen

Answer 39

Vibroacoustic stimulation

Question 40

What is a positive response of a Vibroacoustic stimulation?

Answer 40

Fetal heart rate acceleration

Question 41

What are the other intrapartum assessment technique?

Answer 41

Fetal pulse oximetry Fetal echo Intrapartum Doppler velocimetry

Question 42

What are the two descriptions used to interpret fetal heart rate patterns:

Answer 42

Reassuring | Non- reassuring

Question 43

Suggests a restoration of confidence by a particular pattern

Answer 43

Reassuring

Question 44

Suggest inability to remove doubt

Answer 44

Non-reassuring

Question 45

What are the three theories associated with Meconium in the amniotic fluid?

Answer 45

- Fetal response to hypoxia - Maturation of the GIT - Transient umbilical cord entrapment from Vagal stimulation

Question 46

Amino infusion uses __ ml bolus of warmed normal saline followed by a continuous infusion of approximately ___

Answer 46

500-800ml | 3ml per hour

Question 47

Translational amnioinfusion may be done in the following:

Answer 47

- Treatment of variable to prolonged variable decelerations - Prophylactically in cases of oligohydramnios with PROM - To dilute it wash out thick Meconium