Maternal History Flashcards
Oligohydramnios
low amniotic fluid (AFI <5cm), (SDP <2cm), can result from absent or dysfunctional kidneys, urinary tract obstruction,
OR utero placental insufficiency, maternal meds, maternal dehydration
Prolonged Oligohydramnios can lead to…
Pulmonary hypoplasia if prolonged or during the canicular phase of alveolar proliferation
Polyhydramnios diagnoses
AF >20, SPD (single deepest pocket) >8cm
Polyhydramnios Etiology
3 Categories: decreased absorption, overproduction, and idiopathic
Fetal swallowing is the predominant mechanism of AF removal - so GI abnormalities - tracheal atresia, duodenal atresia, tracheal or bowel obstruction) or neuro (trisomy 18,21, anencephaly)
Polyhydramnios - overproduction causes
Rh-sensitization, IDM, syphilis,
Early Decellerations
Due to fetal head compression, associated with uterine contraction, tend to be V shaped and timed with contractions
Variable Decellations
Due to umbilical cord compression, characterized by rapid down slope and variable recovery, Vary in shape and timing, not necessarily timed with contractions
Late Decellerations
Gradual change, uniform shape, lowest point occurs AFTER peak of contractions, indicative of abnormal acid-base status
Cat I FHR
Baseline HR 110-160, Good variability, no lates or variables
Cat II FHR
Does not meet criteria of either Cat I or Cat III, indeterminate, not indicative of abnormal fetal acid-base balance
Cat III FHR
absent variability, recurrent late or variable decels
Absent or minimal variability
may be seen with progressing hypoxia in cerebral or myocardial tissues;
nonhypoxic causes may be anencephaly, presence of maternal opioids
Sinusoidal patterns
smooth with no variability, common with Rh-sensitized infants with critcal anemia, possibly leading to hydrops, severe cases of fetal-acidemia, and in maternal-fetal bleeding
Magnesium Sulfate before delivery
reduces the incidence of cerebral palsy - it is neuroprotective
Monoamniotic Twinning
single amniotic sac containing both twins; higher risk of morbidity and mortality compared to diamniotic twins
