Ob/Gyn- Fetal Heart Monitoring- Dr. Moulton

Question 1

what monitoring provides most accurate tracings?

Answer 1

internal monitoring

Question 2

what is required in order to use internal electronic fetal monitoring?

Answer 2

membranes must be ruptured

Question 3

what is the Fetal Heart rate determined by?

Answer 3

atrial pacemaker

Question 4

what happens to blood flow to baby with each uterine contraction?

Answer 4

it ceases. myometrial vessels are compressed. can increase or decrease FHR

Question 5

what does the upper and lower tracing on monitoring strip show?

Answer 5

upper= Fetal heart rate 
lower= uterine contractions

Question 6

what is normal uterine activity?

Answer 6

5 or less in 10 mins, averaged over a 30 min window

Question 7

criteria for tachysystole of uterine activity?

Answer 7

> 5 contractions in 10 mins, averaged over a 30-min window

Question 8

normal, baseline for fetal heart rate?

Answer 8

110-160 bpm

Question 9

tachycardia FHR?

Answer 9

> 160 bpm

Question 10

bradycardia FHR?

Answer 10

< 110 bpm

Question 11

what FHR response do chemoreceptors produce in response to hypoxia?

Answer 11

tachycardia

Question 12

what is baseline variability?

Answer 12

irregular amplitude and frequency

Question 13

minimal variability?

Answer 13

amplitude rande detectable but <5 bpm

Question 14

Moderate variability?

Answer 14

(normal) amplitude range 6-25 bpm

Question 15

what are the three possible changes in baseline FHR in response to uterine contractions?

Answer 15

1. no change
2. acceleration
3. deceleration

Question 16

which is a normal abrupt change in FHR?

Answer 16

accelerations

Question 17

three classes of decelerations, which is a good sign?

Answer 17

1. early (good sign)
2. variable (ok)
3. Late (bad)

Question 18

what is you see a smooth, sine wave-like undulating pattern in FHR baseline w/ a cycle freq of 3-5 mins? is it normal?

Answer 18

Sinusoidal patter. abnormal, very concerning

Question 19

what is amnioinfusion?

Answer 19

infusion of normal saline to alleviate cord compression. via the IUPC

Question 20

what is useful in differentiating fetal sleep from acidosis?

Answer 20

Fetal Scalp Stimulation

Question 21

if the umbilical cord were wrapped around the fetus neck, what do you expect the fetal tracing to look like?

Answer 21

VARIABLE decelerations, prolonged decelerations, fetal bradycardia

Question 22

if you your nurse tells you she sees Late decelerations on the fetal tracing, should you be concerned?

Answer 22

yes. sign of fetal distress