MCN (Labor Monitoring)

Question 1

Labor Monitoring

Answer 1

Internal Examination
Electronic Fetal Monitoring

Question 2

Internal Examination

Answer 2

cervical dilatation
ave diameter of cervical opening
measured in cm
admits tip - 10cm (fully dilated)

cervical effacement
degree of decrease in cervical length
measured in %
uneffaced-fully effaced

station
level of presenting part in relation to ischial spines (station 0)
minus (-), zero, plus (+)

membrane
bag of water
unruptured / intact
ruptured

Question 3

Phases of Uterine Contractions

Answer 3

Increment
“building up” or increasing contraction; longest phase

Acme
peak of a contraction

Decrement
period of “letting up” or decreasing contraction

Question 4

Characteristics of Uterine Contractions

Answer 4

Duration
from beginning of one contraction to end of the same contraction
Frequency
from beginning of one contraction to beginning of the next contraction
Interval
resting time between contractions to allow placental perfusion

Question 5

How to read a CTG?

Answer 5

DR: Define risk
C: Contractions
BRa: Baseline rate
V: Variability
A: Accelerations
D: Decelerations
O: Overall impression

Question 6

Define risk

Answer 6

Obstetric complications
Multiple gestation
Post-date gestation
Previous cesarean section
Intrauterine growth restriction
Premature rupture of membranes
Congenital malformations
Oxytocin induction/augmentation of labour
Pre-eclampsia
Obstetric complications
Multiple gestation
Post-date gestation
Previous cesarean section
Intrauterine growth restriction
Premature rupture of membranes
Congenital malformations
Oxytocin induction/augmentation of labour
Pre-eclampsia

Question 7

Contractions

Answer 7

record number of contractions present in a 10/20 minute period
individual contractions are seen as peaks on CTG strip
assess & report contractions by duration, frequency & interval

Question 8

Baseline Fetal Heart Rate

Answer 8

average heart rate of the fetus within a 10/20-minute window
normal FHB 110-160 BPM

Fetal Tachycardia
baseline heart rate greater than 160 bpm

Fetal Bradycardia
baseline heart rate less than 110 bpm

Question 9

Variability

Answer 9

beat to beat fluctuations from baseline heart rate
result of interaction between nervous system, chemoreceptors, baroreceptors and cardiac responsiveness of fetus
indicates how healthy a fetus is at a particular time

Question 10

Accelerations

Answer 10

abrupt increase in baseline fetal heart rate of more than 15 bpm for more than 15 seconds

Question 11

Decelerations

Answer 11

abrupt decrease in baseline fetal heart rate of more than 15 bpm for more than 15 seconds

Question 12

Deceleration
due to Head Compression

Answer 12

Early Deceleration

Question 13

Deceleration Due to Umbilical Cord Compression

Answer 13

Variable Deceleration

Question 14

Deceleration Uteroplacental Insufficiency

Answer 14

Late Deceleration

Question 15

very concerning as it is associated
with high rates of fetal morbidity and mortality
indicates
Severe fetal hypoxia
Severe fetal anaemia
Fetal/maternal haemorrhage

Answer 15

Sinusoidal Pattern