Labor And Birth Flashcards
Sterilization
Destruction of all forms of microbial life
Nonreassuring/ominous patterns
Profound bradycardia, recurrent late and variable decelerations, absent variability
Nonreassuring patterns
Fetal tachycardia
Bradycardia (80-100 bpm)
Saltatory pattern
Variable decels with slow return to baseline
Late decels with normal variability
Ominous patterns
Persistent late decels with minimal variability
Nonreassuring variable decels with minimal variability
Bradycardia <80 bpm for more than 3 minutes,
Sinusodial pattern
Flat tracing with minimal variability
Management of non reassuring/ominous patterns
Explain concerns
Change maternal position
Monitor FHR as frequently as possible
Assess ctx pattern
Give 02
Perform vaginal exam
Scalp stim
Call Ems/transport
Iv fluids
Assess vitals
Assess for cord prolapse
Assess bleeding.
Bradycardia
Rate?
Causes?
Assessments?
Rate: 100-119 bpm the absence of other non-reassuring patterns is not usually a sign of compromise
Etiologies: maternal hypothermia, cord compression or prolapse, canal stimulation, cardiac abnormalities, occipital posterior or transverse position, serious fetal compromise
Assessments: presence of prolapsed cord, duration of bradycardia, presence or absence of variability, late or prolonged variable decelerations, expected time to delivery.
Tachycardia
Rate?
Rate: >160 bpm in the presence of good variability tachycardia is not a sign of fetal distress.
Mild tachycardia 160-180bpm
Severe tachycardia >180bpm
Tachycardia etiologies
Continued tachycardia above 180 bpm suggests chorioamnioitis esp when maternal fever is present
Maternal fever, fetal hypoxia, fetal anemia, amnionitis, fetal tachyarrythmia(usually >200-240 bpm), fetal heart failure, drugs, rebound transient tachycardia following a decel accompanied by decreased variability
Baseline change
The decrease or increase in heart rate lasts longer than 10 mins
Reassuring FHT patterns
Baseline is normal, variability moderate, accelerations present; indicates healthy well oxygenated fetus
Baseline FHR
120-160bpm
Baseline excludes periods of marked FHR variability, periodic or episodic changes, and segments of baseline that differ by more than 25 bpm
Minimum baseline is 2 minutes. If minimum baseline duration is <2 min the baseline is indeterminate
What sets baseline?
Atrial pacemaker sets baseline, best to best variation influenced by sympathetic and parasympathetic ANS
Baseline FHR gradually decreases as fetus ages
