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OB GYN > Intrapartum > Flashcards

Intrapartum Flashcards

0
Q

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

A

EXTERNAL (Indirect) electronic fetal heart rate monitoring

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1
Q

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

A

INTERNAL (Direct) electronic fetal heart rate monitoring

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2
Q

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

A

EXTERNAL (Indirect) electronic fetal heart rate monitoring

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3
Q

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

A

Moving fetal heart valves

Pulsatile blood ejected during systole

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4
Q

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

A

5 bpm

10 minutes

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5
Q

The normal baseline FHR:

A

110-160 bpm

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6
Q

What is the FHR in bradycardia?

A

<110 bpm

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7
Q

What is the FHR in Tachycardia?

A

> 160bpm

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8
Q

This can cause fetal bradycardia:

A 
H - hypoxia
A - arrythmias
B - beta blockers
C - congenital heart blocks
M - maternal hypotension
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9
Q

Causes of fetal tachycardia:

A 
M - maternal fever
F - fetal infection
H - hypoxia
B - beta mimetics
H - hyperthyroidism
A - arrhtyhmia
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10
Q

Baseline FHR Variability:

Amplitude range is undetectable

A

Absent

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11
Q

Baseline FHR Variability:

Amplitude range is 5 bpm or fewer

A

Minimal

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12
Q

Baseline FHR Variability:

Amplitude range of 6-25 bpm

A

Moderate

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13
Q

Baseline FHR Variability:

Amplitude range >25bpm

A

Marked

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14
Q

Significance of a normal FHR variability

A

Excellent indicator of good fetal well being

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15
Q

Causes of decreased or absent variability:

A 
AA - asphyxia / fetal acidemia
S - fetal sleep
P - prematurity
D - magnesium sulfate, diazepam, meperidine
A - atropine
D - defective conduction system
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16
Q

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

A

Reduced baseline heart rate variability

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17
Q

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

A

Sinusoidal fetal heart rate pattern

2-5/minutes persist for >=20 minutes

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18
Q

Fluctuations in the FHR of 2 cycles per minute or greater

A

Baseline variability

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19
Q

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

A

Acceleration

20
Q

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

A

Acidemic

21
Q

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

A

> = 30 seconds

Early deceleration

22
Q

What is the pathophysiology of early deceleration:

A

Head compression > Vaal stimulation > affects the FHR

23
Q

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

A

Late deceleration

24
Q

Causes of late decelerations:

A

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

25
Q

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

A

Variable deceleration

26
Q

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

A

Variable deceleration

27
Q

The most common deceleration pattern encountered during labor

A

Variable deceleration

28
Q

Cause of variable deceleration

A

Umbilical cord compression

29
Q

What are the markers of a prolonged deceleration:

A

Decrease in FHR

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

30
Q

Common cause of prolonged deceleration:

A

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

31
Q

Other causes of prolonged deceleration:

A 
C - conduction analgesia
M - maternal hypothermia
A - abruption
U - umbilical cord prolapse
M - maternal seizure
V - Valhalla maneuver
32
Q

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

A

Fetal scalp blood sampling

33
Q

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

A

Labor is observed

34
Q

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

A

Measurement is repeated within 30 minutes

35
Q

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

A

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

36
Q

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

A

Deliver

37
Q

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

A

Scalp stimulation

38
Q

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

A

Normal pH

39
Q

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

A

Vibroacoustic stimulation

40
Q

What is a positive response of a Vibroacoustic stimulation?

A

Fetal heart rate acceleration

41
Q

What are the other intrapartum assessment technique?

A

Fetal pulse oximetry
Fetal echo
Intrapartum Doppler velocimetry

42
Q

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

A

Reassuring

Non- reassuring

43
Q

Suggests a restoration of confidence by a particular pattern

A

Reassuring

44
Q

Suggest inability to remove doubt

A

Non-reassuring

45
Q

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

A
  • Fetal response to hypoxia
  • Maturation of the GIT
  • Transient umbilical cord entrapment from Vagal stimulation
46
Q

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

A

500-800ml

3ml per hour

47
Q

Translational amnioinfusion may be done in the following:

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

OB GYN (11 decks)

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