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OB Exam 1 > Module 2: Part 3 > Flashcards

Module 2: Part 3 Flashcards

1
Q

What is electronic fetal monitoring (EFM) used for?

A

used to determine the baseline rate and patterns of FHR and their relationship with uterine contractions

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2
Q

How is external fetal monitoring conducted?

A

Involves placing an US transducer and a tocotransducer on mother’s abd to measure FHR & uterine contractions, respectively.

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3
Q

What is internal fetal monitoring, and how is it performed?

A

involves measuring FHR through a wire/electrode containing a needle inserted through vagina and placed on the baby’s scalp.

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4
Q

This method is used when external monitoring is inadequate & cervix is dilated at least 2 cm and the membranes are ruptured

A

internal FHR monitor

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5
Q

normal baseline fetal heart rate (FHR)

A

110 to 160 beats per minute (BPM)

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6
Q

Define bradycardia and tachycardia in terms of FHR

A

Bradycardia: FHR <110 BPM
Tachycardia: >160 BPM

*bradycardia is always bad

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7
Q

fetal bradycardia is seen in

A

hypoxemia

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8
Q

After prolonged bradycardia, the fetus will become tachycardic d/t

A

catecholamine secretion

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9
Q

How is the baseline FHR determined?

A

by assessing the mean HR over a 10 min period, rounded to increments of 5 bpm

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10
Q

What is the difference in baseline FHR between term and preterm fetuses?

A

Term fetuses typically have a lower baseline fetal heart rate than preterm fetuses due to greater PNS activity.

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11
Q

the lowest point in deceleration below the baseline in BPM

A

Nadir

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12
Q

is the highest point in the fetal heart rate tracing

A

Acme

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13
Q

Differentiate between abrupt and gradual decelerations

A

Abrupt decelerations have an onset to nadir (peak) duration of <30 sec
While gradual decelerations have an onset to nadir duration of >30 sec

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14
Q

What characterizes a normal FHR tracing? (4)

A

110–160 bpm
baseline variability
accelerations (in response to fetal movement; good fetal health & oxygenation)
Absence of decelerations

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15
Q

Baseline variability in FHR monitoring

A

fluctuations in the FHR baseline that are irregular in both amplitude and frequency

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16
Q

How is baseline variability quantified visually?

A

measuring the amplitude from peak to trough in BPM, which is then used to classify the tracing

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17
Q

Single most important characteristic of the FHR

A

Baseline variability

Variability, in the proper amount, shows proper functioning ANS
If absent, may suggest fetal compromise

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18
Q

4 types of variability

A

Absent(undetectable, straight line)
Minimal (undetectable, <5 bpm from baseline)
Moderate (6-25 bpm away from baseline)
Marked (>25 bpm from baseline)

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19
Q

(T/F) Absent variability indicates fetus is doing well

A

False
*Dr Rodgers says, “We love variability.”

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20
Q

types of variability: undetectable, straight line

A

absent

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21
Q

Variability is greatly influenced by

A

Parasympathetic tone and vagus nerve

22
Q

when baby is hypoxic during delivery, fetal myocardial and cerebral BF will (increase/decrease) to maintain that O2 during delivery

A

Increase

*it’s normal for baby to be a little hypoxic during delivery bec they are getting stretched and pushed

23
Q

if baby is super hypoxic you will lose

A

fetal baseline variability
*very bad!

24
Q

Decrease variability causes

A

fetal hypoxia
sleeping baby (must stimulate baby!)

25
Q

are accelerations good or bad

A

good!

26
Q

How are accelerations defined in 32 weeks and beyond

A

an abrupt increase above baseline with an acme of ≥ 15 BPM and a duration of ≥ 15 seconds but less than 2 minutes

27
Q

How are accelerations defined in before 32 weeks gestation

A

an abrupt increase above the baseline with an acme of ≥ 10 BPM and a duration of ≥ 10 seconds but less than 2 minutes

28
Q

What is a prolonged acceleration?

A

A prolonged acceleration is defined as an acceleration lasting ≥ 2 min but less than 10 min

29
Q

What typically coincides with the onset, peak, and end of early decelerations?

A

coincide with the onset, peak, and end of uterine contractions

30
Q

What is often the cause of early decelerations?

A

by head compression during labor

31
Q

What are variable decelerations in FHR monitoring?

A

abrupt decreases in FHR typically d/t baroreceptor or chemoreceptor-mediated vagal activity or transient hypoxia

32
Q

How do variable decelerations differ from other types of decelerations?

A

are inherently variable in timing, depth, or shape (u, v, or w) and duration

33
Q

Most common cause of variable decelerations

A

by umbilical cord compression

34
Q

What are late decelerations in FHR monitoring

A

decelerations that begin 10-30 sec. after the beginning of contraction and end 10-30 sec. after the end of the uterine contraction

35
Q

How do late decelerations typically appear?

A

are smooth and repetitive, occurring with each contraction

36
Q

What does the presence of late decelerations along with decreased or absent FHR variability indicate?

A

an ominous sign of fetal compromise

37
Q

Causes of decelerations in decreased uterine blood flow (4)

A

Maternal hypotension
Uterine hyperstimulation
Acidosis and hypovolemia d/t poorly controlled maternal diabetes

38
Q

Causes of decelerations in placental dysfunction (4)

A

Postdate gestation
Preeclampsia
Chronic maternal hypertension
Maternal diabetes mellitus

39
Q

late decels are usually associated with

A

placental insufficiency

40
Q

variable decels are usually associated with

A

umbilical cord

41
Q

early decels are usually associated with

A

baby’s head

42
Q

What are prolonged decelerations in FHR monitoring?

A

Prolonged decelerations are visually apparent decreases in FHR below baseline

Decrease is ≥ 15 BPM, lasting ≥ 2 minutes, but < 10 minutes from onset to return to baseline

43
Q

What is on this strip

A

Good/normal variability
mild acceleration on top (fetus)

44
Q

(T/F) This strip has plenty of variability

A

False
There is an absence of variability (no bueno)
*possible placental abruption

45
Q

early or late decel?

A

early

46
Q

early or late decel?

A

late

47
Q

variable or absence of variability

A

variable

48
Q

know FHR and what kind of decel it is, v wave or u wave and principal cause

A
49
Q

FHR VEAL CHOP

A

know this!
variable- cord compression
early decels- head compression
accels-ok maybe O2
Late decels- placental insufficuency

50
Q

Smooth and Sine wave-like, undulating pattern with a cycle frequency of 3-5 BPM that continues for at least 20 min or more

A

A sinusoidal FHR pattern

*IMPENDING DOOM! very bad sign.

51
Q

Fetal (tachy/brady)cardia is always bad.

A

Brady

brady = bad
hypoxemia

OB Exam 1 (13 decks)

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