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OBGYN > OBN: Fetal Assessment > Flashcards

OBN: Fetal Assessment Flashcards

1
Q

___ is caused by head compression since the vagal nerve is activated

A

Early deceleration

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2
Q

Cite 4 possible causes of uteroplacental insufficiency

A
  1. Maternal hypotension
  2. Excessive uterine activity
  3. Placental dysfunction
  4. Maternal diseases
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3
Q

Abrupt decrease in FHR is defined as decrease from onset to FHR nadir is <30seconds. This suggests ____

A

Cord compression

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4
Q

Normal baseline variability ranges from ___ beats per minute

A

6-25 bpm

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5
Q

Late deceleration is due to ____

A

uteroplacental insufficiency

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6
Q

Severe fatal anemia can lead to this type of pattern

A

Sinusoidal

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7
Q

The cut-off of value for normal uterine contraction

A

less than 5 contractions in 10 minutes

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8
Q

Determine the category.

110-160bpm, moderate variability, no decelerations, no acceleration

A

Category 1

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9
Q

Determine the category.

Absent baseline variability, with bradycardia, recurrent late decelerations, and sinusoidal pattern

A

category 3

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10
Q

A reactive NST means there are ____ accelerations within 20-40 minutes.

A

Reactive.

Note that NST: There should be no contraction present!

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11
Q

What is the normal fetal movement per hour?

A

10 FM up to 2 hours

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12
Q

[Fetal breathing]

What happens to the chest wall and abdomen of the fetus during inspiration?

A
  1. Chest wall collapses

2. Abdomen protrudes

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13
Q

[Fetal breathing]

What happens to the chest wall and abdomen of the fetus during expiration?

A
  1. Chest wall expands
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14
Q

Contraction stress test is a test of ____

A

uteroplacental function

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15
Q

What are the criteria for a satisfactory contraction stress test?

A
  1. 3 or more contractions
  2. 40 seconds or more
  3. 10 minute period
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16
Q

A positive contraction stress test means that there is ___ of the fetal heart

A
  1. Late deceleration following 50% or more of contraction
  2. late deceleration even if the contraction is fewer than 3 in 10 mins

due to uteroplacental insufficiency

this is abnormal

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17
Q

___ is a test of fetal condition

A

Non-stress test

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18
Q

What are the methods in conducting CST?

A
  1. Oxytocin infusion

2. Nipple stimulation

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19
Q

What are the components of BPP?

A

Remember: NST MATaBa 3 2 1 1

SCORE 2 if

  1. NST >/2 accel of >/15 bpm for >/15 sec
  2. Movement = >/3 in 30 min
  3. Amniotic fluid at least 2cm in 2 pockets
  4. Tone >/ 1 episode of extremity extension and subsequent flexion
  5. Breathing >/1 lasting >/ 30sec
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20
Q

[BPP score Recommended management]

8/10

A

Deliver

21
Q

[BPP score Recommended management]

BPP of 6/10
Abnormal fluid volume

A

Deliver

22
Q

[BPP score Recommended management]

BPP of 6/10
Normal fluid, favorable cervix
>36 weeks AOG

A

deliver

23
Q

[BPP score Recommended management]

repeat testing BPP of 6/10

A

deliver

24
Q

[BPP score Recommended management]

BPP of 7/10

A

repeat

25
Q

[BPP score Recommended management]

BPP of 4/10

A

repeat testing same day

26
Q

[BPP score Recommended management]

initial BPP of 4/10; repeated same day becoming 6/10

A

deliver

27
Q

[Neural control of BPS activity]

fetal tone

A

cortex-subcortical area

last affected by asphyxia

28
Q

[Neural control of BPS activity]

what is the first affected BPS parameter in fetal hypoxia?

A

HR

29
Q

[Neural control of BPS activity]

fetal movement

A

cortex-nuclei

30
Q

[Neural control of BPS activity]

fetal breathign

A

ventral surface of 4th ventricle

31
Q

[Neural control of BPS activity]

fetal heart reactivity

A

Medulla and posterior thalamus

32
Q

[Fetal heart rate patterns]

What is the normal HR of a fetus?

A

110-160; minimum 2 minutes in a 10 minute strip

33
Q

[Fetal heart rate patterns]

A moderate variability of FHR mean that the amplitude is between

A

6-25 bpm (NORMA:)

34
Q

[Fetal heart rate patterns: Acceleration]

Normal for >/32 weeks

A

> 15bpm from baseline
lasting 15 seconds
less than 2 minutes

35
Q

[Fetal heart rate patterns: Acceleration]

< 32 weeks

A

> / 10 bpm from baseline
lasting 10 seconds
less than 2 mins

36
Q

[Fetal heart rate patterns: Acceleration]

prolonged acceleration means ___

A

acceleration >2mins but <10 mins

37
Q

[Fetal heart rate patterns: Acceleration]

a baseline change can be implied if the acceleration lasts

A

> / 10mins

38
Q

[FHR abnormalities]

oncet, nadir, and recovery are coincident with the beginning and ending of contraction

A

Early deceleration

39
Q

[FHR abnormalities]

what are the causes of early deceleration?

A
  1. Fetal head compression –> Increase ICP leading to decreased HR
40
Q

[FHR abnormalities]

onset, nadir, and recovery of deceleration occur after the beginning, peak, and ending of a contraction

A

Late deceleration

41
Q

[FHR abnormalities]

what are the causes of late deceleration?

A
  1. Uteroplacental insufficiency;

stimulation of chemoreceptor leading to stimulation of vagal nerve decreasing the HR

42
Q

what is the most common deceleration pattern?

A

variable deceleration

43
Q

Variable deceleration is due to ___

A

umbilical cord occlusion

44
Q

[Intervention]

Recurrent late deceleration, prolonged deceleration, or bradycardia

A
  1. Lateral decubitus positioning
  2. Administer maternal oxygen
  3. Administer IV fluid bolus
  4. Reduce uterine contraction frequency
45
Q

[Intervention]

Tachysystole with Cat II or Cat III tracing

A
  1. Discontinue oxytocin or prostaglandin

2. Give tocolytics (terbutaline, magnesium sulfate)

46
Q

[Intervention]

Recurrent variable decelerations

A

Repositioning of the mother

47
Q

[Intervention]

Prolonged deceleration or bradycardia from umbilical cord compression

A
  1. Amnioinfusion
48
Q

[Intervention]

recurrent variable decelerations, prolonged decelerations, bradycardia with prolapsed cord

A

elevate the presenting part, prepare for delivery

OBGYN (33 decks)

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