Intrapartum monitoring Flashcards
Features that make variable decals complicated?
The following additional features increase the likelihood of fetal hypoxia: - Rising baseline rate or fetal tachycardia.
- Reducing baseline variability.
- Slow return to baseline FHR after the end of the contraction.
- Large amplitude (by 60 bpm or to 60 bpm) and/or long duration (60 seconds).
- Presence of smooth post deceleration overshoots (temporary smooth increase in FHR above baseline).
Recommendations around frequency and duration of intermittent auscultation?
Q15min 1st stage. 30-60seconds duration
Q5 min or with each contraction second stage. Begin near end of contraction, auscultate 30-60seconds.
Which of the following is an absolute reason for CTG monitoring?
- AMA 41yo
- AFI 5-8cm
- Temperature 37.9 degrees
- BMI 43
- GDM, uncomplicated
BMI >40 is absolute indication. Maternal pyrexia only indication if 38 degrees or more. Fluid volume qualifying as oligo or poly are absolute (DVP<2cm, >8cm, AFI <5cm, >20cm)
GDM without medication, well controlled with normal growth by itself is not an indication for cEFM.
define uterine hypertonus
UA lasting more than 2 minutes in duration or occurring within 60s of each other.
define tachysystole
more than 5 contraction in 10 minutes
define prolonged deceleration
A fall in the baseline fetal heart rate for more than 90 seconds and up to 5 minutes
Define fetal bradycardia
A fall in the baseline fetal heart rate for more than 5 minutes
Describe a late deceleration?
Uniform, repetitive decreasing of FHR with, usually, slow onset mid to end of the contraction and nadir more than 20 seconds after the peak of the contraction and ending after the contraction. In the presence of a non-accelerative trace with baseline variability <5 bpm, the definition would include decelerations of <15 bpm.
Indications for cord gases
- FBS sampling during labour
- instrumental delivery for fetal compromise
- Apgar <7 at 5 minutes
- Apgar <4 at 1 minute
