Intrapartum Part 2

Question 1

What are variable decels a sign of?

Answer 1

Cord compression

Question 2

What are early decels a sign of?

Answer 2

Head compression

Question 3

Different FHR devices?
Electronic monitor-intermittent
Fetal scalp electrode?

Answer 3

Electronic monitor-intermittent, Measures fetal heartrate
Fetal scalp electrode, is invasive and required ROM

Question 4

Leopold’s Maneuvers
1,2,3,4? Why?

Answer 4

First palpation feels fetal butt, second feels fetal sides, third feels fetal head, fourth feels fetal sides again. Need to find the back.

Question 5

Tocometer, internal or external? What part of contractions are measured? What part is not accurate?

Answer 5

External monitor, measures frequency and duration of contractions. Not great at measuring strength

Question 6

Internal Monitor, What part of contractions are measured? Units?

Answer 6

Measures frequency and duration of contractions, but can also measure strength.

Question 7

What is the unit in which contraction strength is measured?

Answer 7

Montevideo units

Question 8

How many Montevideo units are a sign of adequate pregnancy in a 10 minute span?

Answer 8

200!

Question 9

Tachysystole?

Answer 9

5 contractions within a 10 minute span

Question 10

Normal fetal HR, Tachycardia, Bradycardia

Answer 10

110-160, Tachy is an average of 160 for >10 minutes, Brady is an average of 110 of >10 minutes

Question 11

Different types of Variability?
Absent?
Minimal?
Moderate?
Marked?

Answer 11

Absent, none
Minimal, less than 5bpm
Moderate 6-25bpm
Marked, greater than 25bpm

Question 12

Causes of tachy?

Answer 12

Early sign Hypoxia, Infection, Anemia, Maternal hypothyroidism, Drugs

Question 13

Causes of brady?

Answer 13

Late sign of fetal hypoxia, drugs, cord compression, maternal hypothermia, maternal hypotension, tachysystole

Question 14

Accelerations in 32 weeks or older?
Younger than 32 weeks?

Prolonged accelerations?

Answer 14

15 bpm above baseline lasting 15 seconds or more

10 bpm above baseline lasting 10 seconds or more

Prolonged, longer than 2 min, less than 10 min

Question 15

What are the causes of decelerations?
Variable?

Answer 15

Variable - abrupt and random
Early - associated with contractions, should return to normal after contraction is finished
Late - BAD
- Sign of uteroplacental insufficiency, begins after contractions?

Question 16

VEAL CHOP?

Answer 16

Variable - Cord Compression
Early Decel - Head compression
Accelerations - Okay
Late Decel - Placental insufficiency

Question 17

Influences of pain during labor - Visceral?

Answer 17

Visceral - Uterine ischemia, cervical changes, uterine changes, referred pain

Question 18

Influences of pain during labor - Somatic pain

Answer 18

Distention and pressure, traction, any lacerations

Question 19

Influences of pain during labor - Psych

Answer 19

Culture
Anxiety
Past experience
Preparation
Support
Environment

Question 20

What is a complication of sedatives during pregnancy?

Answer 20

Prolonged latent phase

Question 21

Systemic analgesia, what’s a complication of this?

Answer 21

Done via IV, crosses placenta. Can cause resp depression of baby

Question 22

Inhaled anesthetics? What’s the effect

Answer 22

Nitrous oxide, minimal effect on baby

Question 23

Regional analgesia types?

Answer 23

Blocks: local tissue, pudendal
Spinal anesthesia: epidural, spinal blocks

Question 24

When do they use general anesthesia during birth

Answer 24

C/S only

Question 25

Gate-control theory

Answer 25

Only so many neural impulses can be transmitted by a nerve, Distraction techniques block some of these, closing a “gate” Engaging in activity involving the spinal cord modifies transmission

Question 26

Non-pharmacological Lamaze? Bradley? Dick-Read?

Answer 26

Lamaze, breathing control Bradley, relaxation aids Dick-Read, emphasized the use of relaxation and proper breathing with contractions as well as family support and education