Intrapartum Fetal Surveillance

Question 1

What can be done to determine if contractions are adequate?

Answer 1

insert intrauterine pressure catheter(IUPC), this can help determine if adequate and if oxytocin is appropriate

Question 2

What are prostaglandins used for and when are they contraindicated?

Answer 2

used for cervical ripening and are contraindicate in pts with prior cesarean due to risk of uterine rupture

Question 3

When is prolonged periods of fetal tachycardia seen?

Answer 3

frequently found with maternal fever or chorioamnionitis

Question 4

what can maternal narcotic analgesia cause on FHR?

Answer 4

decreased variability

Question 5

What is pathophys of early decel?

Answer 5

caused by fetal head compression during uterine contraction, resulting in vagal stimulation and slowing of heart rate

Question 6

What causes variable decelerations?

Answer 6

reflex mediated and usually associated with umbilical cord compression as a result of cord wrapped around fetal parts, fetal anomalies or oligohydramnios

Question 7

What would uterine hyperstimulation cause?

Answer 7

prolonged bradycardia

Question 8

What are initial measures to evaluate and treat fetal hypoperfusion?

Answer 8

a change in maternal position to left lateral position(which increases perfusion to the uterus), maternal supplemental oxygenation, treatment of maternal hypotension, discontinuation of oxytocin, intrauterine resuscitation with tocolytics and IV fluids

Question 9

What is the appropriate fetal stimulation to assess accels?

Answer 9

meta analysis supports gentle digital scalp stimulation as appropriate stimulation method because if acceleration results, it is correlated with fetal pH >7.2 in over 90% of cases; if lack of accel, can assess fetal scalp pH or allis clamp test

Question 10

What is normal baseline fetal heart rate?

Answer 10

110-160